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Books Oliver Sacks: 'I now think of old age as a sort of disease'

The Mind's Eye, the new book by Oliver Sacks, includes a chapter on his own experience of optical illusions after he lost his sight in one eye because of melanoma.

Michael Falco for The Globe and Mail/michael falco The Globe and Mail

Oliver Sacks has devoted much of his life to the obsessive study of human perception.

As a scientist and writer - though his critics would never describe him in that order - he has long been seduced by the bizarre: The man who mistook his wife for a hat, the novelist who woke up to discover he couldn't read the morning paper, the patient who fell asleep for 50 years.

Now, at 77, with his own perception failing him on several fronts, the doctor finds himself, ironically, immersed in the most medically mundane condition imaginable: aging.

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His right ear is deaf. One eye is completely blind, while the other is cloudy with a cataract. He has endured painful surgery on his knee, shoulder and back, which remain sore and stiff such that he walks with a cane.

"I now think of old age as a sort of disease, so I'm already a patient. … Incidentally, it turns out I'm not completely sure that I'm a good one," says the doctor, sitting in his Greenwich Village office, where his desk is cluttered with neurological textbooks, periodic tables and, oddly, the snorkel he uses during his morning swim.

Dr. Sacks's latest book, The Mind's Eye, is an examination of the neurological disorders that affect vision. His interest, however, as always, is not his subjects' disabilities, but rather their curious capacity to compensate for them.

And so we meet Lilian, a celebrated concert pianist who sits down to play Mozart's Piano Concerto No. 21 in front of an audience, but suddenly finds the sheet music unrecognizable. With time, she loses the ability to recognize other objects and to remember, but for some reason her ability to play piano clings on.

We also meet Dr. Sacks himself, not as a doctor but as a patient who is struck with melanoma in his right eye, a diagnosis he was stunned to receive in 2005.

He describes the optical illusions his brain concocts in an effort to compensate for the subsequent loss of his vision, filling in objects in his growing blind spot. He also writes about his frustration with a medical system that can't schedule radiation treatment quickly enough, and his sense of desperation, bargaining at one point with his tumour to take his eye but spare his life.

Dr. Sacks has been both praised and criticized for his ability to write empathetically about science. When he joined the faculty of Columbia University three years ago, he received the new designation of "artist," a nod to both the neurologist and the writer coexisting in him.

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But some scientists scoff at Dr. Sacks's shtick, his propensity to befriend his patients to get their stories, saying it compromises a doctor's necessary objectivity.

Others say he abuses his patients' trust by writing about their misfortunes for a general audience, essentially profiting from their afflictions.

Dr. Sacks bristles at this. Fundamentally, he believes that science and academics versus art and popular writing is a false dichotomy, and a recent one at that. "In the last century, for example, not only [Charles]Darwin's books, but his articles were read by gardeners and pigeon-fanciers and the general public. This divide was not there," he said.

"The average man," he says, "is much more intelligent than one might think."

Spend an hour with Dr. Sacks and you realize his existence is, in some ways, a constant struggle to blur boundaries and collapse walls. His apartment and his office, for example, are separate but interchangeable, both equipped with beds, showers, desks, and typewriters. The British-born neurologist has lived in New York for years, but has never taken U.S. citizenship, preferring the limbo status of "resident alien." At Columbia, he often crosses campus from the medical faculty to the arts faculty where he conducts workshops on creative non-fiction writing.

Dr. Sacks nursed dreams of becoming a journalist early in life, travelling around with a backpack full of journals, but the plan foundered.

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"I felt like I had some writing talent but nothing to write about," he tells me. "I also felt divided between the writing part of me and the scientific part of me, but somehow they've come together," he continues.

He is acutely aware that the way they have done so leaves him vulnerable to criticism, which he wrestles with all the time. He has compared his protectiveness toward his patients with that of a parent for a child, which isn't exactly flattering.

"I think one can become friendly with one's patients, but I think one mustn't try to doctor one's friends," he says, a phrase which I still don't quite understand.

The ethics of being Dr. Sacks are indeed complicated. Over the course of our conversation he tells me he has a 40-year friendship with one of the subjects of an earlier book, who suffers from Tourette's syndrome. Sometimes they interrupt their lunches to discuss various treatments.

In another breath he tells me how he refuses to write about certain patients for The New Yorker, for which he is a contributor, because he worries about subjecting them to the magazine's "remorseless" fact-checkers.

There are some - perhaps dozens - of cases he has written about but not published, because he worries about the consequences of stories being told while either he or his patients are still living.

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"I have dozens of books and articles which have been put away. I don't often look back, but maybe at some future time they can be used - posthumously or whatever. But I feel it would be improper to use them now," he explains, almost apologetically.

Asked how, precisely, he defines his relationship with his patients, he offers an imprecise answer: "It's complex but all I know is that somehow intuition and respect has to be there always."

He also lashes out at scientists who fail to communicate the significance of their work in human terms, regardless of how abstract their work might be. He reads plenty of science journals, he says, but finds "a lot of the stuff impenetrable," which is ridiculous, he says.

"In particular, I think one needs narrative and history to relate how things have come about and how they've happened. … It's not sufficient just to give the result and the conclusion. Even when you are dealing with things that are unimaginably remote from human experience, I think it's important to think about them in a human way," the doctor says, with a pause.

"After all, we are the ones who are midway between the atoms and the stars."

Sonia Verma is a writer for The Globe and Mail.

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