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Table of Contents    
Year : 2019  |  Volume : 67  |  Issue : 3  |  Page : 952-956

Insomniac City. New York, Oliver, and me

Department of Neurosurgery, Jaslok Hospital and Research Centre, Dr. G. V. Deshmukh Marg, Mumbai, Maharashtra, India

Date of Web Publication23-Jul-2019

Correspondence Address:
Dr. Sunil Pandya
Department of Neurosurgery, Jaslok Hospital and Research Centre, Dr. G. V. Deshmukh Marg, Mumbai, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.263210

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How to cite this article:
Pandya S. Insomniac City. New York, Oliver, and me. Neurol India 2019;67:952-6

How to cite this URL:
Pandya S. Insomniac City. New York, Oliver, and me. Neurol India [serial online] 2019 [cited 2020 Aug 12];67:952-6. Available from:

Author : Bill Hayes

Book : New York: Bloomsbury.

Year of publication : 2017

Pages : 304

After the subtitle and the dedication, the next indication of the central character in this account appears in the single well-chosen quotation at the start of the book. “I don't fear death as I do wasting life.”—Oliver Sacks (Sacks made this statement on 31 September 2009, just before he underwent a total knee replacement. This operation worsened his sciatica).

Mr. Hayes gained fame as an author with The Anatomist: A True Story of Gray's Anatomy. This is the book that prompted Dr. Sacks in New York to write to Mr. Hayes in California, praising his work. When Mr. Hayes decided to move to New York, the now famed relationship between the two flourished.

He was also a well-known photographer. The first photograph in this book shows us Cross streets with snow. Taken in the small hours of the night, it depicts a city snowscape devoid of people—a fitting scene for an insomniac.

Since this book, in its title, refers to lack of sleep, let me refer to an earlier book by Mr. Hayes. In Sleep demons: an insomniac's memoir (2001, reprinted in 2018), he had explained, “I grew up in a family where the question 'How'd you sleep?' was a topic of genuine reflection at the breakfast table. My five sisters and I each rated the last night's particular qualities—when we fell asleep, how often we woke, what we dreamed, if we dreamed. My father's response influenced the family's mood for the day: if 'lousy', the rest of us felt lousy, too. If there's such a thing as an insomnia gene, Dad passed it on to me, along with green eyes and Irish melancholy.”

”I lay awake as a young boy, my mind racing like the spell-check function on a computer, scanning all data, lighting on images, moments, fragments of conversation, impossible to turn off. As a sleeping aid, I would try to recall my entire life—a straight narrative from first to last incident—thereby imposing order on the inventory of desire and memory.”

He explains his experience of natural sleep versus that induced by hypnotics in this book: “Sleeping pills can force the body into unconsciousness, it's true. I've slept many times on those delicious, light-blue pillows. But the body is never really tricked. The difference between drugged and natural sleep eventually reveals itself, like the difference between an affair and true romance. It shows up in your eyes. Sleep acts, in this regard, more like an emotion than a bodily function. As with desire, it resists pursuit. Sleep must come find you.”

In the earlier book, we also learnt about other interesting thoughts on sleep: 'Sensitivity to pain is said to be highest at this hour. If you're awake, distractions fall away, I suppose, leaving nerves inflamed, wounds throbbing. Amazingly, dreaming offers a genuine escape from physical pain, a fact that comforted me in the past and will again, I'm sure, as [my partner] and I grow older. Even people with chronic, severe pain during the day are numb to it in the rapid eye movement (REM) sleep—this is the most persuasive argument that dreaming represents a separate biological state, one that can be explosively visual, and yet is free of physical suffering.

”It sounds like heaven. And in a way, it is. Dreaming led early humans to conceive of a spirit that leaves the body during sleep and travels to fantastic places, which in turn inspired notions of a soul and an afterlife. As it was then, heaven is still widely envisioned as an eternal good dream. Hell's both a nightmare and, as Dante imagined the Inferno, a never-ending state of sleeplessness…”

”It's coming up on four o'clock, the very worst time to get a phone call—death occurs most frequently from 4 to 6 A.M. It's as if the old, injured, or ill body, sustained by sunlight, runs out of juice just before dawn. The circadian clock unplugs itself. Lungs collapse. The heart stops. But it's also when most people are sound asleep, so if you were to cry out for help, others would be less likely to hear you. Babies are most liable to die from sudden infant death syndrome right about now.”

”Given that humans, statistically, tend to die when we tend to be born—at night—do we also die, I wonder, as we are born — dreaming? Maybe the white light seen by people who die but 'come back' is like the leader film in home movies—the bright, clear frames before the familiar pictures begin. Life ends in a final, glorious REM surge.”

”If so, I hope it's a damn good dream when I go, one of those extremely rare ones in which all five senses are employed at once: a dream of swimming, say, at the beach on Kauai—a faint taste of briny water, scent of fresh air, waves crashing.”

I shall end this section on sleep and insomnia with one last quote from the chapter Sleep loss: “I cannot help remembering what the Greeks so wisely knew: The God of Sleep has an identical twin, Thanatos, the God of Death.”

Insomniac City is a conglomeration of essays, not necessarily connected or in sequence and is replete with several images captured by his camera. Some of these essays were published earlier in The New York Times. I am reluctant to classify the contents of this book as gallimaufry.

Incidentally, Mr. Hayes's book entitled How New York breaks your heart was published a month ago. Part III of the book under review carries the same title as that book.

You could interpret some of the many, at times haunting, photographs in both these books as indicative of his own wistful emotions as his affection for the city and his eminent and heart-warming partner deepened.

Mr. Hayes is frank about his love for men and recalls, at times with affection, some of his partners before Dr. Sacks came into his life. Steve was the first of them. Three books by Mr. Hayes were dedicated to him. After Steve died from ventricular fibrillation (he also suffered from AIDS) on the 10th of October, Mr. Hayes had 10/10 tattooed “on a pulse point”. After some experimentation—including the use of tequila and weed, Mr. Hayes concluded that “music… was the most effective balm to my grief”. His account of the sorrow occasioned by Steve's death is described in some detail. In the process, he also summarizes how animals and birds show evidence of their anguish.

Dr. Sacks, 30 years older than Mr. Hayes, enters the narrative in the chapter O and I. During their first visit, Mr. Hayes learnt that Dr. Sacks “too, was a lifelong insomniac—indeed, from a family of insomniacs” —the first of many commonalities. “By the end of our lunch I hadn't come to any firm conclusions (on Dr. Sacks' sexual preferences), as he was both very shy and quite formal.” On his return to California, “I sent him photographs I had taken in Central Park of bare tree limbs. I though they looked like vascular capillaries. With his neurologist's eye, he felt they looked like neurons.” Dr. Sacks recalled that Nabokov had compared winter trees to the nervous system of giants.

Dr. Sacks' influence on Mr. Hayes is evident in the second line of the opening chapter itself. “If New York were a patient, it would be diagnosed with agrypnia excitata, a rare genetic condition characterized by insomnia, nervous energy, constant twitching and dream enactment – an apt description of a city that never sleeps, a place where one comes to reinvent himself.” Although Mr. Hayes has worked to help patients with AIDS, he is not a physician but he did suffer from “my own mild agrypnia”.

He shares with Dr. Sacks a love of literature and genius for description. On page 2 of his text, he tells us of his wonder at finding that, “late into the night… (persons) leave behind their sweat-dampened sheets to read in the coolness of a park under the streetlights…” and describes a young man reading a paperback that Mr. Hayes readily identified from the cover as J. D. Salinger's 1951 novel The Catcher in the Rye. He goes on to describe a “middle-aged woman bathed in a light Vermeer would have loved…”

Describing one of his first experiences on moving to New York, Mr. Hayes tells us that he took the subway to Far Rockaway—the wrong direction for getting to Manhattan. We are then provided a glimpse into his philosophy. “But taking wrong trains, encountering unexpected delays, and suffering occasional mechanical breakdowns are inevitable to any journey really worth taking. One learns to get oneself turned around and headed the right way.” There are other subway stories in this book, especially in Subway lifer.

The first of the chapters entitled Notes from a journal starts thus: “5-9-09: O says I must keep a journal. And so, I must. I make notes on scraps of paper, the backs of envelopes, cocktail napkins. Sometimes dated, sometimes not” (as did Dr. Sacks himself). One such note reads, “How I take a shower with the sun, a bird and a squirrel watching me.”

In The summer Michael Jackson died, we learn that O had no idea who Michael Jackson was. “What is Michael Jackson?”, he asked me the day after the news—not who but what … O often said that he had no knowledge about popular culture after 1955, and this was not an exaggeration. He did not know popular music, rarely watched anything on the television but the news, did not enjoy contemporary fiction and had zero interest in celebrities or fame (including his own). He did not possess a computer, had never used e-mail or texted, he wrote with a fountain pen… I learned that not only had he never been in a relationship, but he had never come out publicly as a gay man… he hadn't had sex in three-and-a-half decades…'

In the following chapter, Notes from a journal (distinct from the similarly entitled chapter referred to above) is this account:

”7-09-09: O's 76th birthday: After I kiss him for a long time… he has a look of utter surprise on his face, eyes still closed… 'And if I hold you closely enough, I can hear your brain,' I tell him.” In another chapter with the same title is this undated note: “The difference between us in two words. Me, too, I say. I, too, O corrects.”

In another similar chapter we find this entry: “6-9-10:…. O is not able to look at them (clouds) because he had surgery to remove a blood clot in his right eye (from which a melanoma had been removed earlier)…”

And on 8-17-10: “I mention I saw fireflies in Abingdon Square Park… O: Did you keep your mouth shut? I: What do you mean keep my mouth shut? O: They say three will kill you – luciferase – dangerous stuff. I am laughing but he is not… O: I don't want you to die of fireflies… a luminous death!”

Taken together, parts of these Notes from a journal resemble the jottings of James Boswell on his exchanges with Dr. Samuel Johnson.

Mr. Hayes records interesting facts such as Dr. Sacks' preference for a blend of smoky Lapsang Souchong and brisk Darjeeling tea. Another example is Dr. Sacks' list of all the elements NOT present in the human body. (He lists 20 elements. I wonder how many you would have on a similar list). Dr. Sacks also preferred to study “the positive pathologies” in neurology. When asked to clarify the term, he said, “Things like the zigzagging of migraine auras, tics, spasms, seizures – excesses, hypertrophies of physiology, not losses, absences.” We also learn of Dr. Sack's topographical agnosia when walking the streets of New York and the lesson he learnt from his physiotherapist to prevent his walking stick from falling when propped up against something – cover the head with rubber bands. He also admitted to being a hypochondriac at times!

The description of how Dr. Sacks confirms his feeling that the phrase a handsome apprehension of heaven is from the writings of Sir Thomas Browne (1605-1682) is fascinating, as is the episode when Dr. Sacks wondered what it was like to be a rose.

On Father's Day describes Mr. Hayes' meeting with the old—now demented—soldier who fails to recognize him as his son. The poignancy of this narrative is striking.

The encounters with Ali (from Pakistan), who worked in a smoke shop are memorable (the owner of the store was an Indian and a fellow-worker was a Sikh). The pathos as the old man faced deteriorating social manners is touching. Mr. Hayes was sufficiently fascinated by Ali to write about him in The New York Times (Lessons from the smoke shop, 31 May 2014).

There is much to learn on the appreciation of art in A Monet of one's own. Incidentally, we learn here that Dr. Sacks was “a self-described philistine when it comes to art.”

I shall content myself with merely providing you the headings of some other chapters to excite your curiosity: A poem written on the stars, The thank-you man, The same taxi twice, The weeping man, On being not dead, My afternoon with Ilona (the unusual 95-year old artist).

In a recording made by the British Broadcasting Corporation (BBC), Dr. Sacks described his expectations as a patient facing the doctor. “Everyone has a right to know what goes on in medicine and in accessible and non-condescending language. I think that medicine needs to be tender, tactful and, at times, lyrical, as well as precise and analytical. I don't think that these compete with one another or need to.”

The chapter entitled BUT… chronicles the recurrence of Dr. Sacks' uveal melanoma after nine years with extensive metastases. On seeing the findings on the scan, “what has stuck with me so clearly is how calmly Oliver took the news. It was as if he were expecting it…” He told the young doctor offering chemotherapy that he was not interested in “prolonging life just for the sake of prolonging life”. This chapter and those that follow, in themselves, make the book worth reading. I shall reproduce just one quotation from these pages. “I say I love writing, but really it is 'thinking' I love – that rush of thoughts – new connections in the brain being made. And it comes out of the blue.” O smiled. “In such moments I feel such love of the world, love of thinking…”

Dr. Sacks had earlier described to Mr. Hayes (whose mother was dying then) the event after his own mother's death. “He urges me to go out with friends and have some laughs. 'When my mother died,' he tells me, 'my oldest friend called up straightaway and told me three scandalously obscene jokes in a row. I laughed uproariously, and then the tears came.' I follow his advice.”

Imagining his own death, Dr. Sacks felt “not troubled in the least – not serene but… as if it is the right thing at the right time…”

I recommend this volume to all those fond of Dr. Sacks and are keen to learn more about him and Mr. Hayes. It allows us to imbibe the quintessence of these men more effectively than any of their other books has done.

Oliver Sacks, W. H. Auden and Megrim

In Web of Stories(, Dr. Sacks introduces us to the word megrim.

”In this poem, Talking to Myself, by… (the English-American poet, Mr. W. H. Auden), there's one line about chastising his tantrums with a megrim, because he knew I liked the word 'megrim', the old word for migraine...”

”It's a poem looking at himself and particularly looking at age and deterioration and hoping that when the time comes, there won't be any real deterioration up here, but he will bugger off quickly…”

The Merriam-Webster dictionary has an interesting explanation of the origin of the word.

The History of Megrim Could Be Headache Inducing

”Megrim” and “migraine” share a meaning and an etymology.

”Latin and Greek speakers afflicted with a pain in one side of the head called their ailment 'hemicrania' or 'hēmikrania,' from the Greek terms hēmi-, meaning “half,” and kranion, meaning “cranium.”

”French-speaking sufferers used 'migraine,' a modification of 'hemicrania,' for the same condition.”

”English speakers borrowed 'migraine' from French—twice. First, they modified the French term to form 'migreime,' which in turn gave rise to 'megrim' in the 15th century. Later, in the 18th century, they returned to French and borrowed 'migraine' again, this time retaining its French spelling. Nowadays, 'megrim' and 'migraine' can still be used interchangeably, but 'megrim' has other meanings as well.” (

Mr. Auden was as unusual an individual as was Dr. Sacks. In the course of a conversion with Dr. Sacks, he described himself as “a drunk but not an alcoholic”. When asked the difference, he explained, “An alcoholic has a personality change after a drink or two, a drunk can drink as much as he wants and he doesn't have a personality change. I'm a drunk.” Dr. Sacks amplified this conclusion: “He certainly drank a great deal… and sometimes at a dinner, either at his own place or someone else's, he would leave the meal at 9.30 taking every bottle off the table. But, however much he drank he was up at six and at work the next morning.”

The poem, Talking to myself is not easily accessible, so, for the interested reader, I reproduce it below along with its dedication to Dr. Sacks:

Talking to Myself

(For Oliver Sacks)

W.H. Auden

Spring this year in Austria started out benign,

the heavens lucid, the air stable, the about

sane to all feeders, vegetate or bestial:

the deathless minerals looked pleased with their regime,

where what is not forbidden is compulsory.

Shadows, of course, there are, Porn-Ads with-it clergy

and hubby next door has taken to the bottle,

but You have preserved Your poise, strange rustic object,

whom I, made in God's image but already warped,

a malapert will-worship, must bow to as Me.

My mortal manor, the carnal territory alloted to my manage,

my fosterling too, I must earn cash to support,

my tutor also, but for whose neural instructions I could never acknowledge what is or imagine what is not.

Instinctively passive, I guess, having neither fangs nor talons nor hooves nor venom, and therefore too prone to let the sun go down upon Your funk,

a poor smeller, or rather a censor of smells, with an omnivore palate that can take hot food.

Unpredictably, decades ago,

You arrived among that unending cascade of creatures spewed from Nature's maw.

A random event, says Science.

Random my bottom !

A true miracle, say I, for who is not certain that he was meant to be?

As You augmented and developed a profile, I looked at Your looks askance.

His architecture should have been much more imposing: I've been let down!

By now, though, I've gotten used to Your proportions and, all things considered, I might have fared far worse.

Seldom have You been a bother. For many years You were, I admit, a martyr to horn-colic (it did no good to tell You-But I'm not in love!):

how stoutly, though, You've repelled all germ invasions, but never chastised my tantrums with a megrim.

You are the Injured Party for, if short-sighted, I am the book-worm who tired You, if short-winded as cigarette addicts are, I was the pusher who got You hooked.

(Had we been both a bit younger, I might well have mischiefed You worse with a needle.)

I'm always amazed at how little I know You. Your coasts and outgates I know, for I govern there, but what--goes on inland, the rites, the social codes,

Your torrents, salt and sunless, remain enigmas: what I believe is on doctors' hearsay only.

Our marriage is a drama, but no stage-play where what is not spoken is not thought: in our theatre all that I cannot syllable

You will pronounce in acts whose raison-d'etre escapes me.

Why secrete fluid when I dole, or stretch Your lips when I joy?

Demands to close or open, include or eject, must come from Your corner, are no province of mine (all I have done is to provide the time-table of hours when You may put them):

but what is Your work when I librate between a glum and a frolic?

For dreams I, quite irrationally, reproach You.

All I know is that I don't choose them

: if I could, they would conform to some prosodic discipline, mean just what they say.

Whatever point nocturnal manias make, as a poet I disapprove.

Thanks to Your otherness, Your jocular concords, so unlike my realm of dissonance and anger,

You can serve me as my emblem for the Cosmos: for human congregations, though, as Hobbes perceived, the apposite sign is some ungainly monster.

Whoever coined the phrase The Body Politic?

All States we've lived in, or historians tell of, have had shocking health, psychosomatic cases, physicked by sadists or glozing expensive quacks

: when I read the papers, You seem an Adonis.

Time, we both know, will decay You, and already

I'm scared of our divorce: I've seen some horrid ones.

Remember: when Le Bon Dieu says to You Leave him!

please, please, for His sake and mine, pay no attention

to my piteous Dont's, but bugger off quickly.

April 1971

(See the YouTube film - = N0SRba9OSx8 to hear Dr. Oliver Sacks read this poem).


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