Oliver Sacks (1933–2015) Neurologist Who Made House Calls
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COMMENT OBITUARY Oliver Sacks (1933–2015) Neurologist who made house calls. he final stage of life, Dante wrote, equilibrium. In response to injury or disease, is like a ship, gradually lowering its people go through a phase of adaptation sails at the approach of the harbour. and reorganization, often mobilizing inner TIt is a serene image of destination — and resources that have previously lain dormant. eminently unfit to characterize the final According to Sacks, it is the physician’s task decade of Oliver Sacks’s life. Against a tide to help patients to achieve a new order by of diminishing health, he added four books being sensitive to these altered orientations. to an already impressive catalogue: Musi- As Sacks indicated in On the Move, ELENA SEIBERT/CORBIS OUTLINE cophilia (2007), The Mind’s Eye (2010), growing up at a time when homosexuality Hallucinations (2012) and — only months was still listed as a mental disorder by the ago — On the Move, a candid sequel to his American Psychiatric Association alerted childhood memoir Uncle Tungsten (2001). him to the sometimes detrimental conse Several more books are nearly finished. quences of psychiatric labelling. Rather than Oliver Wolf Sacks, who died in New York locking individuals in a ‘condition’, he took City on 30 August, was born in London in the upbeat perspective of pointing out the 1933 into a large Jewish family. His father benefits over the deficits — sometimes to was a general practitioner, his mother a the point of eclipsing the original pathology. surgeon. His aunts and uncles were inven In many cases, this had a liberating effect: tors, chemists and physicians. He grew up one may have Tourette’s syndrome and still with the sense that it was a family duty to be become a surgeon, or, like Grandin, have ‘scientific’. In 1939, at the start of the Second autism and have a career in science. Sacks World War, he was sent away to a board thought in terms of neurodiversity — the ing school in the English Midlands. Sacks, idea that conditions result from normal who would rather have been in danger with variation — well before the term became his family than safe without them, spent noticed such diverse reactions from patient common among those who distanced four miserable years there. The experience to patient that he adapted what was initially themselves from the medical perspective scarred him for life: “sent away” is how he intended to be a conventional double-blind on autism. put it 75 years later in the opening sentence trial to a series of case histories, which he Sacks saw himself as a storyteller, not a of On the Move. published in 1973 as Awakenings. theorist. He often said that he was happy to Reunited with his family in 1943, Sacks After reading Awakenings, Russian neuro present the case material that others could developed a passion for chemistry. Although psychologist Aleksandr Luria sent Sacks a use to devise grand theories. But each story, he eventually chose to study medicine, con letter. He praised Sacks’s talent for observa of course, is a theory. Like Goldstein and templation of the periodic table never ceased tion and description, which reminded him Luria before him, he let his case histories to soothe him in times of turbulence. Sacks of the nineteenth-century tradition of the shore up the theory of the brain as an organ studied at Queen’s College, University of neurological narrative. Much of what was that should be understood holistically, as Oxford, UK, qualifying as a physician in to become vintage Sacks unfolded from this an organism capable of plasticity and com 1958. He left for the United States in the book. His work was case-oriented rather pensation. Although not the inventor of the early 1960s and began five years of medical than population based, descriptive and inti neurological narrative, Oliver was certainly training, interspersed with riding motor mate rather than detached. And he wrote its culmination. For the coming decades, his cycles, working out in gyms, experimenting books, not series of papers in neurologi legacy will be safe in the hearts and minds of with amphetamines and lifting weights on cal journals. To this he added his signature millions of readers. Muscle Beach, California. When a stint in a approach of making house calls. He tried to In conversation, I once brought up his neurochemistry lab ended with a resound meet his ‘cases’ in their natural surround numerous honorary degrees, awards and ing, “Sacks, you are a menace in the lab! Why ings. He observed, for example, a surgeon fellowships — but Oliver was quick to raise don’t you go and see patients — you’ll do less with Tourette’s syndrome while he was oper his hand to halt me, and said simply that he harm”, he decided to do just that. In 1965, he ating; visited Temple Grandin, a woman with believed he was a good doctor. He felt that took up consulting at Beth Abraham Hospi autism, in her office in the animal-sciences his parents recognized that he had become tal in the Bronx, New York. department of Colorado State University in a careful and perceptive neurologist. Even In its wards he encountered some 80 sur Fort Collins; and immersed himself in the in his eighties, being a good son was still a vivors of the ‘sleepy sickness’ pandemic of the world of deaf culture. defining ambition of his life. ■ 1920s. He found them to be frozen, mostly, in The case histories in The Man who a statuesque, ‘parkinsonian’ state. High doses Mistook His Wife for a Hat (1985) secured Douwe Draaisma is professor of the history of the Parkinson’s disease drug l-dopa ‘awoke’ him a worldwide audience. It also helped of psychology at the University of Groningen them from their lethargy, but — as indicated to articulate his scientific credo. Taking in the Netherlands. He interviewed Oliver by their vocabulary, likes, dislikes and skills — inspiration from German neurologist Kurt Sacks in 2005 for his book The Nostalgia in a state of mind belonging to 40 years before Goldstein, Sacks came to think of neurologi Factory and stayed in contact with him. and in a world that was no longer theirs. Sacks cal disorders as challenges to finding a new e-mail: [email protected] 188 | NATURE | VOL 525 | 10 SEPTEMBER 2015.