Once a conspicuous loner, Sacks is now a remarkably recognizable, avuncular public figure. He has been played by Robin Williams in Awakenings, in a performance that came seventeen years after the publication of Sacks’s book; satirized by Bill Murray in The Royal Tenenbaums; and lionized by Richard Powers in The Echo Maker. He is, himself, an even more curious character.
Sacks has been getting migraines, the subject of his first book, since the age of 3 or 4, accompanied always with visual hallucinations. (“I usually ignore it, but if it’s a peculiarly pretty one, I relish it,” he says.) These “hallucinations in the sane” are the main subject of Hallucinations, which also surveys drug-induced ones, which Sacks has also experienced. He has written about face-blindness, which he has, and place-blindness (difficulty remembering spaces), which he says he also has, and deafness, which he increasingly has. He lost his stereoscopic vision in 2006 from ocular melanoma, and he has written about that, too, in The Mind’s Eye, his eleventh book. He’s returned several times to the subject of his third book, A Leg to Stand On, which recounts his own experience of growing disassociated from one of his legs while it healed in a cast—a kind of reverse phantom-limb syndrome. “I’m an honorary Tourette’s because I tend to jerk,” he’s said. “I am also an honorary Asperger. And I’m an honorary bipolar. I suspect we all have a bit of everything.”
Sacks’s most notable problem, though, is what his friends tactfully call his “shyness,” and which he calls a “disease.” In his telling, his childhood was virtually friendless through middle adolescence; he doesn’t understand what people could possibly like about him; and he’s spent most of his adulthood in a state of acute, even paralytic loneliness, rescued only by work. “I had never been in a situation of such safe intimacy with other human beings,” he has said of the time ministering to the semi-catatonic patients of Awakenings.
“I once heard a radio program about people who’d been evacuated in the war as children, as I was,” Sacks says. “And one of the men there, who’d had rather a bad time, now seemed to be fine, but said he felt he was deficient in the three B’s: belief, belonging, and bonding. And I would say that a bit for myself. I’m a friendly guy, but there’s always a certain, almost uncrossable distance.” Later, a little sadly, he goes further. “I never initiate contact. It’s a little bit like some of my Parkinsonian patients, who can’t initiate movement but can respond to music or a thrown ball.”
He has been in psychoanalysis, continuously and with the same Freudian interlocutor, for 46 years—remarkable for a materialist neurologist. “We were both young men, and now we’re old men. There’s a longitudinal study for you,” he says. The two remain on formal terms: “He’s still Dr. Shengold, and I am still Dr. Sacks,” he says. “I think that a patient can become a friend, but that one shouldn’t be a doctor to a friend—there is a distance, which paradoxically allows closeness, as I feel with my own patients.”
Sacks says his shyness simply “doesn’t occur” in those interactions, which may be one reason he is so good with his patients and another reason he so loves them. In his work as a physician, the social landscape is unusually even-planed, for him and for them, and he has an uncanny ability to put his patients at ease—with sustained attention; curiosity and empathy; and a physician’s bag, stuffed with balls, a reflex hammer, and magazines, that could serve a clown. “Among other things, I’m a good and sometimes involuntary imitator,” Sacks says a little mischievously.
It is hard to resist the impression, when visiting him, that you are on a house call, in part because he routinely refers to himself as a “case.” Uncomfortable as it makes me to play doctor, I do take notes. His right eye is a boiling red, and his fly is left unzippered. He lifts up his pants to show the scar from that long-ago broken leg. Apologizing for having only one working hearing aid, he sits down, wedged between two special pillows, at cross-purposes to me: “I may seem to be turning away from you, but really I’m turning toward you.” Looking mostly at the floor just beyond his feet, he speaks at a deliberate pace, meandering from abstract questions on neurology to particular episodes and patients.
He moves in the opposite way when asked about himself, drifting into characterizations that present his own life at a safe distance. “I think there was probably a rather long lost period in which I functioned. I passed exams, I had a good memory, I was clever,” he says. He describes himself as a graphomaniac (having published now a dozen books, with just as many unpublished or discarded) and a babbler (“Things gush out of me, for better or for worse, incontinently”). But the feeling you get in his audience is of fastidious control, a man keeping the world at a safe distance—as though the wilted-flower persona is a genuine but therapeutic performance, benefiting his patients, his readers, and Sacks himself. “I’m sorry I’ve been a little evasive,” Sacks tells me at one point, offering one of many apologies for running off track. “But, what the hell, one has to be.”