Oliver Sacks: An anthropologist on Mars. Seven paradoxical tales
Author : Oliver Sacks
Publishers : New York: Alfred A. Knopf
Year : 1995
Pages : 340; Paperback
Readers of this journal are already familiar with the life and work of Dr. Oliver Sacks through the short but comprehensive obituary note by Dr. Apoorva Pauranik. This note also provided an account of the meeting Dr. Pauranik had with Dr. Sacks in New York. “He was a genius who did not make one feel a lesser mortal.”
Many of our readers will be familiar with his books entitled The Man Who Mistook His Wife for a Hat, Migraine and Awakenings. Many more will have marveled at the superb portrayal of Dr. Sacks by that consummate actor, Mr. Robin Williams, in the film also named Awakenings. Those who have not yet had the good fortune of reading Dr. Sacks' gentle and sympathetic obituary on Mr. Williams would do well to find it under the apt title – The Man Who Could Be Anyone (2014).
Anthropologist on Mars provides “seven paradoxical tales.”
The two quotations at the start of the book sum up the contents. “The universe is not only queerer than we imagine, but queerer than we can imagine.”
“Ask not what disease the person has, but rather what person the disease has.” Dr. Sacks tells us that this is “Attributed to William Osler.” This precaution may have been prompted by the fact that some authorities have ascribed it to other great physicians of the past, starting with Hippocrates of Cos.
In his preface, Dr. Sacks tells us that he wrote this book using his left hand although he is “strongly right handed” as he had had injured that shoulder and was not permitted to use the right arm. (He wrote all his books by hand and had them transferred to the computer by his secretary.) Ruminating on the consequences of his injury and its effects on his entire body, he concluded that “defects, disorders, diseases … play a paradoxical role by bringing out latent powers, developments, evolutions, forms of life, that might never be seen or even be imaginable in their absence … if they destroy particular paths … they may force the nervous system into making other paths and ways ….” This explains the use of the phrase seven paradoxical tales in his subtitle.
The essay carries the same title as the book and the explanation for this title appears at the end of the book. Following on the heels of the essay on autism and autistic prodigies (p. 188–243), it describes the life and work of Dr. Temple Grandin. Mary Temple Grandin deserves this special treatment. At home, she was referred to by her middle name to distinguish her from an Irish girl also named Mary, who worked for the family. At the age of 2 years, Temple was diagnosed to have “brain damage.”
Her mother – Anna Eustacia Purves – was the grand-daughter of the man who invented the autopilot for aircraft. She chanced upon an essay on autism and found in it the clue to Temple's neurological abnormality. With the help of supportive mentors, she helped Temple overcome her handicaps and the taunts that they occasioned.
Autism was brought into prominence through the work of Leo Kanner and Hans Asperger in the 1940s. Dr. Sacks points to the differences between them. “Kanner seemed to see it as an unmitigated disaster, where Asperger felt that it might have certain positive or compensating features – a 'particular originality of thought and experience, which may well lead to exceptional achievements in later life'.”
At the suggestion of William Carlock, a science teacher who had worked for National Aeronautics and Space Administration (NASA), Temple built the “hug box” that has, since, soothed many with the spectrum of disorders under the umbrella term “autism.” (On pages 262–265, Dr. Sacks provides a vivid description of the conception and creation of this box by Dr. Grandin and its effects on her and on Dr. Sacks, as he tried it himself.) Dr. Grandin helped break down the shame and stigma that persons labeled “autistic” labored under. She was one of the first adults to openly announce her illness. She has gone on to become an expert on animal behavior and has been included in the TIME magazine's 100 most influential people in the world under the category “Heroes.” You get a glimpse of her contributions and witness her love for animals when you accompany Dr. Sacks around her animal farm and later the slaughter-house where she made several innovations to help minimize the stress in animals about to be killed (p. 265–280). Do not miss the episode where she saved Dr. Sack's life (p. 294–295) or her thoughts on religion and how she hopes to pass on something worthwhile by the time her life ends (p. 296).
The chapter has several sections describing her interactions with people. On pages 285–286, we learn of the reasons for her celibacy. In a lecture, this remarkable lady concluded, “If I could snap my fingers and be nonautistic, I would not – because then I wouldn't be me. Autism is part of who I am.”
Dr. Sacks summarized her achievements, “… one of the most remarkable autistic people of all: in spite of her autism, she holds a Ph.D. in animal science, teaches at Colorado State University and runs her own business.”
This is a “must-read” chapter (along with that preceding it) for anyone wishing to learn about autism. It also provides the explanation for the title of essay and book. During his meeting with Dr. Grandin, Dr. Sacks asked her how she responded to Greek myths and drama. Dr. Grandin replied that she had “sequencing difficulties” when dealing with back-and-forth narratives and could not empathize with the characters. “Much of the time, I feel like an anthropologist on Mars.”
In each chapter, Dr. Sacks draws lessons on the workings of different parts of the brain and on the nebulous entity – the mind – in health and in disease.
Prodigies (p. 188–243) describes phenomenally gifted autistic individuals. In this chapter, we are provided extracts from the work by Kanner and Asperger. The examples of “singular talents” in such individuals are gathered from 18th century onward. We are introduced to artists, prodigious calculators, individuals with uncanny memories, persons who are capable of complex creations (including a guillotine that almost killed an attendant), athletes, acrobats, and others. Dr. J. Langdon Down, “one of the greatest observers in this realm,” coined the term idiot savant. He described giving one of his patients Gibbon's Decline and Fall of the Roman Empire only to find that he had memorized the entire book after a single reading! He skipped only one line – where he detected and corrected an error. On reaching this page, he would skip the line, go back, correct it, and proceed further.
Dr. Sacks takes us along as he visits and travels with some of the prodigies, witnesses, and analyses their creativity and provides us illustrations from their work on eight unnumbered pages (between p. 202 and 203).
The first essay in the book describes a successful artist (Mr. L) who suddenly finds himself color blind after a cerebral concussion. Soon after the injury, he could not decipher letters but as this improved, he saw everything as though he was “viewing a black and white television screen.” Dr. Sacks sought the help of his friend, ophthalmologist, Dr. Wasserman, and the two studied Mr. L over succeeding weeks and months. The change from the state where everything had a distasteful, dirty look to the state where Mr. L could resume painting and even adding a single color (that he could not see) is recorded in fair detail. We are provided four pages of his art before he lost the perception of color and as he progressively resumed painting. Over time, he also experimented with sculpture, which he had never attempted earlier, turning to additional forms of expression of his artistic skills. Dr. Sacks discusses the neurological basis of the perception of color and what may have gone wrong in Mr. L's brain. In doing so, he describes the contributions of Locke, Newton, Goethe (who wrote on his theory of color perception), Helmholtz, Clerk Maxwell, Edwin Land (who invented Polaroid photography), Gordon Holmes, David Ferrier, Robert Louis Stevenson, Semir Zeki, Francis Crick, Damasio, and others.
The last hippie (p. 42-76) contains Dr. Sacks' discussion on damage by a large meningioma to the frontal and temporal lobes and the diencephalon in Greg F. The feelings of Greg's parents as they watched the conversion of a “lean, hairy son (into) a fat and hairless (person with) a continual stupid smile …,” their dismay at his total blindness, “idiotic comments,” and a state where they felt “like he was scooped out, hollow inside” are well described. Dr. Sacks follows Greg's course after surgery, analyses the basis for each of his neurological deficits – especially that of amnesia – and records how, after such damage, “there is no differentiation … of the grand, the trivial, the sublime, the ridiculous … all these being mixed up and treated as equal.”
In passing, Dr. Sacks also refers to the neurological basis for and the practice of frontal lobotomy and psychosurgery. The reproduction of a segment of Robert Lowell's poem describing the lobotomized Lepke (p. 63) will interest many readers. (Also see Lowell 1976.)
In the course of his discussion, Dr. Sacks ranges far and wide through the literature of medicine in this as in his other essays. In doing so, he provides us startling insights. Consider this quotation from Fluorens: “The brain secretes thought as the liver secretes bile.” (Jean-Pierre Fluorens lived between 1794 and 1867 and proved by experiments that the mind was located in the brain, not the heart).
A surgeon's life (p. 77–107) is of special interest as it describes the life and work of Dr. Carl Bennett – a victim of Tourette's syndrome – who developed into a successful and safe surgeon. After tracing our understanding of this syndrome (on which he has written extensively), Dr. Sacks tells us about people with Tourette's syndrome– even severe forms – who have succeeded in different walks of life as writers, mathematicians, musicians, actors, disc jockeys, construction workers, mechanics, and athletes. Dr. Sacks knew of nine successful surgeons, three internists, two neurologists, and one psychiatrist with Tourette's syndrome.
This account – as with the other essays in the book – amplifies our understanding of the illness and provides insights into the minds and lives of the afflicted. We also learn how they transcend their handicaps with admirable success.
The remaining two essays describe equally interesting individuals.
To see and not to see (p. 108–152) tells us about Virgil, who had been blind since the age of 6 years but was able to see after removal of cataract just before he got married at the age of 50 years. Dr. Sacks quotes the question put to John Locke by William Molyneux, whose wife was blind: “Suppose a man was born blind, and now adult, and taught by his touch to distinguish between a cube and a sphere [be] made to see: [could he now] by his sight, before he touched them, distinguish and tell which was the globe and which the sphere?” In his essay written in 1690, Locke decided that the answer was “No.” In 1709, George Berkeley concluded that there was no necessary connection between the tactile world and a sight world – that a connection between them could only be established on the basis of experience. In 1728, William Cheselden successfully removed cataracts from the eyes of a 13-year-old boy, who was born blind. “Despite his high intelligence, there were profound difficulties with the simplest visual perceptions. He had no idea of distance … space or size. And he was bizarrely confused by drawings and paintings ….”
Virgil had been virtually blind since childhood. He had thick cataracts and retinitis pigmentosa. Surgery to remove cataracts was performed hesitantly as he planned to get married. Dr. Sacks tells us of his subsequent progress. With him, we accompany Virgil as he undergoes a series of tests and travels on a number of varied local expeditions, including one to see a gorilla for the first time.
The landscape of his dreams (p. 153–187) is the story of Franco Magnani who was famed for the photographic accuracy of his drawings after he had seen a landscape just once. Not only could he draw the scene immediately after he had observed it, but he could do so with undiminished accuracy months and even years later, not only from the viewed perspective but also from different angles and as though he had seen it from a hundred of more feet above. “It was as if Magnani held in his head an infinitely detailed three-dimensional model of his village, which he could turn around and explore, mentally, and then reproduce on canvas with total fidelity.”
There are unexpected historical nuggets as we journey with Dr. Sacks. On pages 18 and 19, for example, we learn that an eye of the great chemist John Dalton still resides, pickled, on a shelf in Cambridge. His vast range of knowledge enables him to bring up relevant concepts and findings enunciated decades or even centuries earlier. His search of the literature on any given topic is truly exhaustive.
Like all other books by him, as we finish reading this volume, Dr. Sacks leaves us full of admiration for his wisdom, width and depth of interests, tenacity, ability to recreate vivid scenes, and enlighten.