On the move A life

Oliver W. Sacks

Book - 2015

Physician and writer Oliver Sacks recounts his experiences as a young neurologist; his physical passions--weight lifting and swimming; his love affairs, both romantic and intellectual; his guilt over leaving his family to come to America; his bond with his schizophrenic brother; and the writers and scientists--Thom Gunn, A. R. Luria, W. H. Auden, Gerald M. Edelman, Francis Crick--who influenced him.

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Subjects
Published
New York : Alfred A. Knopf 2015.
Language
English
Main Author
Oliver W. Sacks (-)
Item Description
"This is a Borzoi book."
Includes index.
Physical Description
397 pages, 32 un-numbered pages of plates : illustrations ; 22 cm
ISBN
9780385352543
  • On the Move
  • Leaving the Nest
  • San Francisco
  • Muscle Beach
  • Out of Reach
  • Awakenings
  • The Bull on the Mountain
  • A Matter of Identity
  • City Island
  • Voyages
  • A New Vision of the Mind Home
  • Home
  • Acknowledgments
  • Index
Review by Choice Review

Published only four months before his death, this autobiography of Oliver Sacks provides an exuberant peek into the life of its author. The book skips back and forth through time but primarily focuses on Sacks's career, publications, relationships, and adventures from the early 1960s into the 2000s. This includes but is not limited to anecdotes and expositions of his family, interactions with various writers and scientists, personal affairs, and experiences with drugs, weight lifting, and motorcycles. Sacks trained as a neurologist and treated patients throughout his life, yet he also found time to write numerous books that appeal not only to fellow professionals but to the general public as well, e.g., Awakenings, The Man Who Mistook His Wife for a Hat, and Musicophilia (CH, Apr'08, 45-4287). On the Move is an engaging and candid introduction to a man who transcended the life of a clinical practitioner to become a medical storyteller and humanitarian. Sacks's prose reflects his intelligence, drive, enthusiasm, and, most especially, curiosity about the world. This book is a striking tale of an unorthodox individual and a pleasure to read. Summing Up: Highly recommended. All readership levels. --Carrie Leigh Iwema, University of Pittsburgh

Copyright American Library Association, used with permission.
Review by New York Times Review

MEDICINE IS DOMINATED by the quants. We learn about human health from facts, and facts are measurable. A disease is present or not present; a reckonable proportion of people respond to a particular drug; the inability to predict gene-environment interactions reflects only a failure to map facts we will eventually be able to determine; and if the observable phenotype varies for an established genotype, the differences must be caused by calculable issues. In this version of things, the case histories that constituted most of medical literature up to the early 20th century reflect a lack of empirical sophistication. Only if we can't compute something are we reduced to storytelling, which is inherently subjective and often inaccurate. Science trades in facts, not anecdotes. No one has done more to shift this arithmetical naïveté than Oliver Sacks, whose career as a clinician and writer has been devoted to charting the unfathomable complexity of human lives. "All sorts of generalizations are made possible by dealing with populations," he writes in his new memoir "On the Move," "but one needs the concrete, the particular, the personal too." The emergent field of narrative medicine, in which a patient's life story is elicited in order that his immediate health crisis may be addressed, in many ways reflects Sacks' belief that a patient may know more about his condition than those treating him do, and that doctors' ability to listen can therefore outrank technical erudition. Common standards of physician neutrality are in Sacks' view cold and unforgiving - a trespass not merely against a patient's wish for loving care, but also against efficacy. Sacks has insisted for decades that symptoms are often not what they seem, and that while specialization allows the refinement of expertise, it should never replace the generalism that connects the dots, nor thwart the tenderness that good doctoring requires. A reasonable corollary to the Delphic injunction to "know thyself" is to know thy patient, and few physicians have devoted themselves more unstintingly to such inclusive knowledge than Sacks. Patients want coherence, which can be achieved only when the contradictory essentials of experience are assembled into a fluid account. The doctor must not only listen, but also process what he has heard. Sacks' interest, however, is not merely in helping his patients construct their stories, but also in recounting them to the rest of us. The ethics of that undertaking have often been questioned - most notably, perhaps, by the disability activist Tom Shakespeare, who described Sacks as "the man who mistook his patients for a literary career." Janet Malcolm's assertion that "every journalist who is not too stupid or too full of himself to notice what is going on knows that what he does is morally indefensible" has a particular relevance to Sacks: When the journalist is a doctor, the exploitation of trust is particularly complicated. Sacks' decision to write about his own patients as uncanny specimens (in this book, he reproduces a note that describes a dancing patient as "an idiot Nijinsky") can feel at odds with the careful sensitivity with which he has clearly listened to and observed them. Sacks has long grappled with this dichotomy, and it surfaces repeatedly in his memoir. He does not play down the anger of some patients who have felt betrayed by his portrayals of them, nor does he deny his frustration with wary ones who resisted being depicted. He also reports patients who felt deeply satisfied to read their tales in print - who believed that Sacks had transformed their lonely struggles into heroic exemplars of dignity. Sacks neither dodges nor pursues these moral quandaries at the root of his work; this memoir is more a history of his career than an analysis of it. For decades, his oeuvre has pointed to very high boundaries with most people, startlingly low ones with his patients, and rather muddled ones with his readers. His delving accounts of the invalids he treats have until now stood in stark contrast to his restraint about revealing himself deeply, even though autobiographical threads run through such books as "A Leg to Stand On," "Uncle Tungsten" and "Hallucinations." A doctor - concerned, engaging, humane, eccentric and unforthcoming - has occupied the foreground in his self-description. With "On the Move," he has finally presented himself as he has presented others: as both fully vulnerable and an object of curiosity. The most attractive and most problematic qualities of his writing turn out to be what are best and worst in him. His immersion in his patients' brokenness is mirrored here in his acknowledgment of his own brokenness, his belated empathy for his younger self. He was evacuated from London during World War II to a boarding school where he was often beaten by a sadistic headmaster; he had a brother who developed schizophrenia; he realized he was homosexual as a teenager in the 1940s, in those Alan Turing years when prejudice was at its apex. Medical training pressed him toward aloofness. "There has to be, along with fellow feeling and sympathy and compassion, a sort of detachment so that one is not drawn into a too-close identification with patients," he explains. His life battle has been both to sustain such detachment and to overcome it. After many years of sidestepping the question of his sexual orientation, Sacks has finally written about being gay, recalling his mother's horror at the news (he was 18; she said, "I wish you had never been born"), his early love affairs, the prolonged sexlessness of his midlife, and his recent, happy coupledom with the writer Bill Hayes. Sacks' writing about sexuality is both labored and moving; this is still rough topography for him. In his younger days, he was astonished that someone he had been seeing might be in love with him, and alarmed by the belated discovery that he had "broken his heart." His transition into celibacy is presented without explication. "After that sweet birthday fling, I was to have no sex for the next 35 years," he writes. But why not? He explains only that he had trouble with "bonding, belonging and believing." Sacks has cared for many people - especially his patients - but the kind of love on which marriages are based seems to have been not merely elusive, but bewildering to him (though he has been seeing the same psychoanalyst for nearly 50 years). Sacks did not so much avoid convention as fail to notice it; he understands difficult facets of the human experience with singular clarity, but emotional rules that are legible to most people seem to bewilder him. The primary mark of a good memoir is that it makes you nostalgic for experiences you never had, and Sacks captures the electrifying discoveries he made, especially those in his early career, with vivid, hard-edge prose. He is compelling describing his romance with motorbikes, which he rode across vast distances in his youth, crisscrossing much of North America and Britain, and his obsession with the most extreme kind of bodybuilding; in his late 20s, he could readily squat lift 600 pounds. He conveys the consuming intensity of his writing practice; the sudden insights and ensnaring perils of the drug addiction that nearly killed him; and the expatriate's permanent yearning for the country he isn't in, missing the United States while in England and vice versa. He expresses the endemic sadness of remembrance toward the end of life, when the bad recollections remain sad, and the good ones are infused with the melancholy of their transience. He does not disguise the persistence of his guilt about those whom he introduced to drugs, or whom he did not love enough or see enough or help enough. Neither does he renounce his vendettas against those who willfully hurt him, including a supervisor who criticized his manuscript, fired him and then plagiarized from it, and the authorities who sacked him and expressed disapprobation for his choosing to play with autistic patients rather than apply a reward-and-punishment model, an apparent whimsy now borne out as sound practice. "On the Move" sometimes stumbles in a way typical of celebrity autobiographies - which is to say that being already interested in Sacks will give you patience with details of how his housekeeper cooked fish or his long swims around City Island that other readers may find unexciting. Parts of the book are bracingly innocent; parts are snobbish, with extended descriptions of his good reviews, banal disquisitions on famous friends (his cousin Abba Eban, the poet Thom Gunn, W.H. Auden, Francis Crick, Robert De Niro, Stephen Jay Gould, etc.) and a slightly pompous sequence about meeting the queen when she made him a Commander of the Order of the British Empire. Sacks assumes sometimes that we know more of his past than we do, and sometimes that we know less. Parts of this undertaking read dismayingly like the book one might write for one's grandchildren. THOUGH HE IS not at ease in the world, Sacks wants its notice; his face has appeared on the cover of several of his books, as it does, rather fetchingly, on this one. The poignancy of this shy exhibitionism permeates this book. He describes one of his patients as having a "compulsion to be seen and shown, to exhibit himself, but also to hide from sight"; he could be describing himself. The most touching part of the book is the exposition of his relationship to his Aunt Lennie, who seems to have given him a confidence that his quietly accomplished parents failed to instill. "Len's belief in me had been important since my earliest years," he writes, "since my parents, I thought, did not believe in me, and I had only a fragile belief in myself." Later, he muses: "It was not easy to believe that anyone cared for me; I sometimes failed to realize, I think, how much my parents cared for me. It is only now, reading the letters they wrote to me when I came to America 50 years ago, that I see how deeply they did care." The writing of this book must have helped in that healing, which gives it considerable pathos. As a young man, Sacks wrote to his parents that he could repay their benevolence by "leading a fairly happy and useful life," and he appears to have kept that promise. He is enamored of humanity despite often finding individual people difficult, splendidly inclined to what he characterizes as "childish, ingenuous enthusiasm." In writing about fellow scientists - especially the Nobel laureate neuroscientist Gerald Edelman - he demonstrates undimmed intellectual vigor, and drives toward an agnostic theory of life as awash in both conscious and unconscious choices, and thus permanently suffused with possibility. This position entails the rejection not of particular facts, but of the tyranny of facts altogether. He angered members of the medical establishment early in his career because, he writes: "I had cast doubt on predictability itself. I had cast contingency as an essential, unavoidable phenomenon." He has always been, he writes, "haunted by the density of reality." To clinicians, Sacks generally seems a very good writer, and to lay readers, he often seems a remarkable doctor, but the extent of his distinction in either area has been subject to question. His writing sometimes has a tinge of exposé, and there is no evidence that his clinical skills outrank those of other neurologists. To dismiss him on either of these fronts, however, misses the central fact that translating between those two arenas has great value of its own. Sacks' ability to enact and celebrate intuition in medicine and precision in art is singular. In comparing himself to the poet Thom Gunn, he writes, "Thom, even then, was lapidary and incisive; I was centrifugal and effusive." Edelman's vision of an essentially "individual, personal world" gave Sacks "the feeling of having been liberated ... from a world of shallow, irrelevant computer analogies into one full of rich biological meaning." This freedom in turn led him to conclude, "Individuality is deeply imbued in us from the very start, at the neuronal level.... We are destined, whether we wish it or not, to a life of particularity and self-development, to make our own individual paths through life." Sacks' first major book, in 1973, was "Awakenings," which inspired a documentary, a play by Harold Pinter and a feature film. The title is telling. Though he explicitly addresses the reviving of patients long caught in Parkinsonian catatonia caused by encephalitis, the real accomplishment of this and his subsequent books has been the larger awakening to the idea that medicine itself sits rightly at the intersection between literature and science. ANDREW SOLOMON, a professor of clinical psychology at Columbia University Medical Center; is the author, most recently, of "Far From the Tree: Parents, Children and the Search for Identity."

Copyright (c) The New York Times Company [May 10, 2015]
Review by Booklist Review

*Starred Review* Sacks characterizes himself primarily as a storyteller, the son of storytellers mother and father both rather than as a physician, the other identity he shares with both parents. He's melded those roles in a string of best-selling collections of case histories from his practice as a clinical neurologist. Anyone pleased by any of them will be enthralled with his own story, which he fills out with not just the personal reasons, such as making fascinating friends, but also the scientific ones, such as contributing to new conceptions of brain function, that make what he tells us worth telling. He also, perhaps all unawares, reveals himself as a restless achiever and a bit of a daredevil. If avidly reading historic medical literature from adolescence on seems entirely appropriate to a writing clinician, surely youthful passions for motorcycling and weightlifting (on early-'60s Muscle Beach, yet) are a bit surprising (when injuries quashed those pursuits, Sacks fell back on hard swimming and scuba diving). And if strong late friendships with the stars of brain research seem inevitable, others begun well before he was famous, such as with the poets W. H. Auden and Thom Gunn, attest the estheticism in him that is the mainspring of his 2007 best-seller, Musicophilia. That Sacks is homosexual barely glints among the other lights of his long, eventful life. HIGH-DEMAND BACKSTORY: That the author's previous books have been popular in libraries should more than suggest that most public librarians need to have this new one in their collection.--Olson, Ray Copyright 2015 Booklist

From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review

Sacks, an esteemed neurologist and the author of such bestsellers as Awakenings (1973) and The Man Who Mistook His Wife for a Hat (1983), offers a candid memoir chronicling his colorful personal and professional journey, made all the more poignant given his recent diagnosis of terminal cancer. Actor and voice-over artist Woren delivers a generally pleasant and competent reading of the audio edition of the momentous title. Yet somehow his delivery does not match the emotional power found in Sacks's narrative. It doesn't help matters that-even though Sacks is a native of the United Kingdom-Woren chooses not to add any traces of a British accent in his performance of the first-person elements of the book, though he does provide a mix of accents for various supporting figures sprinkled into the real-life events. Given such intense subject matter as wild experimentation with LSD and similar hallucinogens in the 1960s, extreme sports and California body-building culture, mingling with the literary and pop-culture elite of the past half century, and of course numerous groundbreaking medical discoveries, Woren's mild approach just doesn't fit the occasion. A Knopf hardcover. (Apr.) © Copyright PWxyz, LLC. All rights reserved.

(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review

Sacks's (The Man Who Mistook His Wife for a Hat) memoir engages listeners in the many and varying tales of his life, from his work with patients to his love of motorcycles. What makes this work especially compelling is the author's wonderful way of telling a story. Sacks is known for his skill in translating the art and science of medicine into accounts that are enjoyed by a wide range of people; his memoir is told with the same appealing style and is read with flair by Dan Woren. The audio version is a good choice for on-the-go listening as it is presented in smaller segments and can be followed without remembering all of the previous details. VERDICT This title will appeal to those who are interested in medicine and in Sacks as well as those who want to hear the life story of a doctor who may not fit the preconceived notion of a physician. ["For fans of Sacks, those who enjoy biographies, and anyone with an interest in medical or neurological work": LJ 4/15/15 review of the Knopf hc.]-Eric D. Albright, Tufts Hirsh Health Science Lib., Boston © Copyright 2015. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Review by Kirkus Book Review

The prolific physician's adventure-filled life. Sacks (Neurology/NYU School of Medicine; Hallucinations, 2012, etc.) continues where he left off in Uncle Tungsten (2001), the story of his youthful fascination with chemistry. Describing himself as quiet, shy, and solitary, he nevertheless has become a man of many passions: science, medicine, motorbikes, and, for years, assorted drugs, including cannabis, LSD, amphetamines, and chloral hydrate. Sacks writes candidly of his mother's rage when she learned he was homosexual, and he ruefully recalls several brief love affairs. Sent away from his family during World War II, he believes, caused him to feel inhibited in intimate relationships. But he celebrates many close friendships, notably with fellow physician (and entertainer) Jonathan Miller and poet Thom Gunn, and he offers a touching portrait of his brother Michael, who was schizophrenic. Sacks went to Oxford aiming to become a research scientist, but after one project failed dismally, he followed family tradition and studied medicine (both parents and two brothers were physicians). After working at Middlesex Hospital in England, he took an internship at Mount Zion Hospital in San Francisco, where he fell in love with the lifestyle and landscape, buying a motorcycle and taking to the road every chance he had. "By day I would be the genial, white-coated Dr. Oliver Sacks," he recalls, "but at nightfall I would exchange my white coat for my motorbike leathers, and, anonymous, wolf-likerove the streets or mount the sinuous curves of Mount Tamalpais." By the time he left California in 1965, he had covered 100,000 miles. Sacks loved clinical medicine, vividly evoking his observations and investigations in Awakenings (1973), Seeing Voices (1989), and An Anthropologist on Mars (1995). The Man Who Mistook His Wife for a Hat (1985) made the New York Times bestseller list and, to his surprise, catapulted him to fame. Despite impressionistic chronology, which occasionally causes confusion and repetition, this is an engaging memoir by a consummate storyteller. Copyright Kirkus Reviews, used with permission.

Copyright (c) Kirkus Reviews, used with permission.

Muscle Beach When I finally made it to New York in June of 1961, I borrowed money from a cousin and bought a new bike, a BMW R60--the trustiest of all the BMW models. I wanted no more to do with used bikes, like the R69 which some idiot or criminal had fitted with the wrong pistons, the pistons that had seized up in Alabama. I spent a few days in New York, and then the open road beckoned me. I covered thousands of miles in my slow, erratic return to California. The roads were wonderfully empty, and going across South Dakota and Wyoming, I would scarcely see another soul for hours. The silence of the bike, the effortlessness of riding, lent a magical, dreamlike quality to my motion. There is a direct union of oneself with a motorcycle, for it is so geared to one's proprioception, one's movements and postures, that it responds almost like part of one's own body. Bike and rider become a single, indivisible entity; it is very much like riding a horse. A car cannot become part of one in quite the same way. I arrived back in San Francisco at the end of June, just in time to exchange my bike leathers for the white coat of an intern in Mount Zion Hospital. During my long road trip, with snatched meals here and there, I had lost weight, but I had also worked out when possible at gyms, so I was in trim shape, under two hundred pounds, when I showed off my new bike and my new body in New York in June. But when I returned to San Francisco, I decided to "bulk up" (as weight lifters say) and have a go at a weight- lifting record, one which I thought might be just within my reach. Putting on weight was particularly easy to do at Mount Zion, because its coffee shop offered double cheeseburgers and huge milk shakes, and these were free to residents and interns. Rationing myself to five double cheeseburgers and half a dozen milkshakes per evening and training hard, I bulked up swiftly, moving from the mid-heavy category (up to 198 pounds) to the heavy (up to 240 pounds) to the superheavy (no limit). I told my parents about this--as I told them almost everything--and they were a bit disturbed, which surprised me, because my father was no lightweight and weighed around 250 himself.1 I had done some weight lifting as a medical student in London in the 1950s. I belonged to a Jewish sports club, the Maccabi, and we would have power-lifting contests with other sports clubs, the three competition lifts being the curl, the bench press, and the squat, or deep knee bend. Very different from these were the three Olympic lifts-- the press, the snatch, and the clean and jerk--and here we had world-class lifters in our little gym. One of them, Ben Helfgott, had captained the British weight-lifting team in the 1956 Olympic Games. He became a good friend (and even now, in his eighties, he is still extraordinarily strong and agile).2 I tried the Olympic lifts, but I was too clumsy. My snatches, in particular, were dangerous to those around me, and I was told in no uncertain terms to get off the Olympic lifting platform and go back to power lifting. The Central YMCA in San Francisco had particularly good weight-lifting facilities. The first time I went there, my eye was caught by a bench-press bar loaded with nearly 400 pounds. No one at the Maccabi could bench-press anything like this, and when I looked around, I saw no one in the Y who looked up to such a weight. No one, at least, until a short but hugely broad and thick-chested man, a white-haired gorilla, hobbled into the gym--he was slightly bowlegged--lay down on the bench, and, by way of warmup, did a dozen easy reps with the bench-press bar. He added weights for subsequent sets, going to nearly 500 pounds. I had a Polaroid camera with me and took a picture as he rested between sets. I got talking to him later; he was very genial. He told me that his name was Karl Norberg, that he was Swedish, that he had worked all his life as a longshoreman, and that he was now seventy years old. His phenomenal strength had come to him naturally; his only exercise had been hefting boxes and barrels at the docks, often one on each shoulder, boxes and barrels which no "normal" person could even lift off the ground. I felt inspired by Karl and determined to lift greater pound- ages myself, to work on the one lift I was already fairly good at--the squat. Training intensively, even obsessively, at a small gym in San Rafael, I worked up to doing five sets of five reps with 555 pounds every fifth day. The symmetry of this pleased me but caused amusement at the gym--"Sacks and his fives." I didn't realize how exceptional this was until another lifter encouraged me to have a go at the California squat record. I did so, diffidently, and to my delight was able to set a new record, a squat with a 600-pound bar on my shoulders. This was to serve as my introduction to the power-lifting world; a weight-lifting record is equivalent, in these circles, to publishing a scientific paper or a book in academia. 1. My father would eat continually in the presence of food but go all day without food if it was not available; it is similar with me. In the absence of internal controls, I have to have external ones. I have fixed routines for eating and dislike deviations from them. 2. Helfgott's achievement was all the more extraordinary because he had survived the camps at Buchenwald and Theresienstadt. Excerpted from On the Move: A Life by Oliver Sacks All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.