Monday, 31 August 2015

RIP Oliver Wolf Sacks

Oliver Wolf Sacks, CBE (9 July 1933 – 30 August 2015) was an English neurologist and author, famous for writing best-selling case histories of his patients' disorders, with some of his books adapted for film and stage. - Wikpedia

Oliver Sacks, who has just died, was an amazing man. A neurologist who was a very shy man, and yet saw his patients as human beings.

This comes out very strongly in his second book, Awakenings. This detailed the miraculous recovery, then tragic relapse, of the near-catatonic patients given the experimental drug L-dopa.

Frozen in a decades-long sleep, these men and women were given up as hopeless until 1969, when Dr. Sacks gave them the then-new drug L-DOPA, which had an astonishing, explosive, “awakening” effect. Dr. Sacks recounts the moving case histories of these individuals, the stories of their lives, and the extraordinary transformations they underwent with treatment.

It was brought to life wonderfully in the movie “Awakenings” with Robin Williams, another wonderfully talented individual no longer with us. Sacks made one request: that the name of the doctor be changed to Sayers.

A medical review noted that:

Normally, films that are based upon actual events take a great deal of liberty in changing the details of the events that they depict. Awakenings appears to be an exception to this trend. Although the names of people involved are changed,... the movie seems to depict a particular disease and the drug used to treat it very accurately. Robin Williams did a good job imitating the personality and mannerisms of Oliver Sacks as the renamed Dr. Sayer.

The film has few inaccuracies, as the review by Andrew Clapper notes: "Rather than starting L Dopa treatment with one patient and then expanding to all of the EL patients as depicted in the film, Oliver Sacks actually began his study as a double blind procedure with a placebo group and a treatment group. He also originally intended to conduct the study for 90 days. Once he saw that fifty percent of his patients were showing improvement, Sacks went ahead and began giving all of the patients L Dopa and dropped the 90 day limit on the study. Sacks' decision to do so is a good example a particular bioethics issue."

But Sacks also had a brilliant BBC documentary he made on the subjects of his book “An Anthopologist on Mars”, in which he speaks to many people, and uncovers the person, not the symptom. There is a surgeon with tourettes – apparently in operating conditions, the twitching motions just vanish away. And Temple Grandin, such a clever autistic woman, who invites him round and lacks all the social niceties, offering a cup of tea, seeing if he is tired and wants a break!

WH Auden, reading Sack’s first book, “The Man Who Mistook his wife for a Hat”, told him: “You’re going to have to go beyond the clinical. Be metaphorical, be mythical, be whatever you need.”

And no one can doubt that Sacks did.

Last week, I was listening to the Radio 4 “Book of the Week”, which was entitled “On the Move”, in which he describes his life – it is a painfully honest memoir, full of regrets despite his successes, and one in which at least he find love in his old age.

That was after gruelling treatment for a tumour in the eye, in which Sacks was both fearful, and amazed, describing the way in which his vision distorted under treatment, and the new ways he saw the world. That was nine years ago.

Unfortunately while ocular melanoma was removed, leaving him blind in that eye, he as he himself says, unlucky that the cancer had spread to his liver. In the New York times, he wrote about this, and I finish this posting with some extracts from that (the full link is given afterwards). Like all that he wrote, it is inspiring.

Oliver Sacks on Dying

It is up to me now to choose how to live out the months that remain to me. I have to live in the richest, deepest, most productive way I can. In this I am encouraged by the words of one of my favorite philosophers, David Hume, who, upon learning that he was mortally ill at age 65, wrote a short autobiography in a single day in April of 1776. He titled it “My Own Life.”

Over the last few days, I have been able to see my life as from a great altitude, as a sort of landscape, and with a deepening sense of the connection of all its parts. This does not mean I am finished with life.

On the contrary, I feel intensely alive, and I want and hope in the time that remains to deepen my friendships, to say farewell to those I love, to write more, to travel if I have the strength, to achieve new levels of understanding and insight.

I feel a sudden clear focus and perspective. There is no time for anything inessential. I must focus on myself, my work and my friends. I shall no longer look at “NewsHour” every night. I shall no longer pay any attention to politics or arguments about global warming.

This is not indifference but detachment — I still care deeply about the Middle East, about global warming, about growing inequality, but these are no longer my business; they belong to the future. I rejoice when I meet gifted young people — even the one who biopsied and diagnosed my metastases. I feel the future is in good hands.

I have been increasingly conscious, for the last 10 years or so, of deaths among my contemporaries. My generation is on the way out, and each death I have felt as an abruption, a tearing away of part of myself. There will be no one like us when we are gone, but then there is no one like anyone else, ever. When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.

I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.

Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.

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