An Anthropologist on Mars:
Seven Paradoxical Tales
By Oliver Sacks
Knopf, 328 pages, $24
Ten years have passed since the publication of Oliver Sacks’ “The Man Who Mistook His Wife for a Hat,” probably the first collection of medical case studies ever to earn best-sellerdom. Like a good many of its scientifically illiterate readers, I found the book spellbinding, for Sacks, a clinical neurologist, unveiled an entire medical specialty to the lay public as few physicians ever do. Before, I pictured neurologists as aloof empiricists probing gray matter in pools of formaldehyde. Tourette’s syndrome was an uncontrollable compulsion to swear, autism severe retardation, and the brain an organ as workmanlike as a turbine. Did I have a lot to unlearn.
In accessible, often suspenseful narratives as bizarre as the fictional tales of Borges and Kleist, Sacks has illustrated efforts to understand migraine, deafness, epilepsy, amnesia; to decode deficits in perception, memory and emotion; and in so doing has demythologized some of the brain’s most byzantine workings. More remarkably, he has rendered the lives of his patients with breathtaking empathy. Some critics call his views partisan; others complain that he strays toward pomposity. Such quibbles aside, his compassion, eloquence and drive to make sense of our senses, to know how we know, are gifts we are lucky he chooses to share.
“An Anthropologist on Mars” comprises seven new chapters in Sacks’ lifelong romance with the brain, each one a multifaceted masterpiece. More deftly than ever, he portrays his subjects with feeling and humility, interweaving through each tale a vivid history of what we know-and don’t know and once thought we knew (and to what tragic ends)-about each disorder described.
Sacks announces the book’s unifying theme in its epigraph (attributed to William Osler): “Ask not what disease the person has, but rather what person the disease has.” The brain, as Sacks has shown before, is the dynamic engineer of the self, with an almost cunning ability to compensate for defects in its own structure and functioning. Here, he delves specifically into how those so-called defects “can play a paradoxical role, by bringing out latent powers, developments, evolutions, forms of life, that might never be seen, or be imaginable, in their absence.” We see disease in service to pathology, disease as the linchpin of self-expression and personal fulfillment.
Psychic seizures convey photographic recall-a “bardic memory”-on Franco Magnani, a man consumed by an ecstatic, Proustian obsession to recreate his childhood homeland, a bucolic village from which he was exiled decades before he begins to portray it in painstaking detail.
Another artist, an abstract expressionist Sacks refers to as Jonathan I., becomes abruptly and totally colorblind at age 65 after a mild concussion. His response to this freak catastrophe and to the nightmare it makes of his life is the riveting foreground to an exegesis of how our knowledge of chromatic perception continues to evolve. Quoting theorists from Newton, Locke and Goethe to Edwin Land, Sacks describes how we have learned that “colors are not `out there’ in the world, nor . . . an automatic correlate of wavelength, but, rather, are constructed by the brain.”
In “The Last Hippie,” a young man drawn to the pacifist counterculture in the early 1970s joins Swami Bhaktivedanta’s temple, where, over four years, the worsening symptoms of a brain tumor are hailed by Greg F.’s fellow ascetics as signs of holy enlightenment. His parents intervene and the tumor is removed, but irreversible damage to the frontal lobes leaves him blind, lethargic, disaffected and with a retrograde amnesia that prevents him from retaining any events after 1970. Greg’s passion for rock music, particularly the Grateful Dead, becomes his last link to the world.
In “To See and Not to See,” a real-life cautionary fable, sight is restored to a 50-year-old man after 45 years of blindness. Through Virgil’s experience, Sacks incisively reveals how the blind do not “lack seeing” but negotiate a universe so richly constructed according to other senses that they can accommodate the “gift” of sight only, if at all, through great trauma.
Subjects of two other histories-the biologist-engineer Temple Grandin, one of two autistics portrayed, and “Carl Bennett,” a surgeon with Tourette’s syndrome-are people conventionally viewed as having forged independent, successful lives “despite” profound inborn defects; Sacks shows how, on the contrary, their diseases are integral to their accomplishments.
Bennett’s story is a particular joy to read. Here is a man who runs a popular practice in an idyllic setting; who is loved by his wife and sons, respected by patients and colleagues; who, despite extreme physical tics, can fly an airplane and perform a mastectomy. He is obsessed with “symmetrizing” his world through touch-persistently balancing his glasses, smoothing his mustache, jabbing at the windshield while driving. He lunges out complusively, marks circles on the ground with a foot, has “flinging tics” and utters “sudden, high-pitched vocalizations, in a voice completely unlike his own, that sounded like `Hi, Patty,’ `Hi, there,’ and, on a couple of occasions, `Hideous!’ ” (Patty, we learn later, was a former girlfriend, her name now enshrined in a tic.)
Like Sacks, we can hardly wait to see how this man performs work that requires the utmost control and dexterity. That Bennett, a peer of his observer, can offer insights on his own behavior makes this portrait even more memorable.
Yet however intrinsically compelling these stories may be, it is the author’s knack for detail that makes them so moving. Observing the crisis of restored sight, Sacks describes how Virgil, who has led a tactile life till now, can no longer tell his cat from his dog when they greet him at the door. And because he has no experience of visual distance, his ability to walk is severely impaired:
“Sometimes surfaces or objects would seem to loom, to be on top of him, when they were still quite a distance away; sometimes he would get confused by his own shadow (the whole concept of shadows, of objects blocking light, was puzzling to him) and would come to a stop, or trip, or try to step over it.”
Conveying the horror of the colorblind painter, Sacks tells us how Jonathan I. saw the world not in clean black-and-white-TV hues but in dirty, stained shades. Socializing was difficult, sex impossible:
“He saw people’s flesh, his wife’s flesh, as an abhorrent grey; `flesh-colored’ now appeared `rat-colored’ to him. This was so even when he closed his eyes, for his vivid visual imagery was preserved but was now without color as well. . . . He found foods disgusting due to their greyish, dead appearance and had to close his eyes to eat. But this did not help very much, for the mental image of a tomato was as black as its appearance.”
He now shunned music, which he had experienced as “a rich tumult of inner colors.” In mourning and denial, “he would glare at an orange in a state of rage, trying to force it to resume its true color. He would sit for hours before his (to him) black lawn, trying to see it, to imagine it, to remember it, as green.”
Sacks’ eloquence also lends power to his discussion of controversial issues in psychiatric protocol. In “The Last Hippie” he offers a succinct and terrifying history of lobotomy. Few dispute the shamefulness of that medical fad, but Sacks goes beyond moralizing to sound a cautionary note as well on our current enthusiasm for pharmaceutical cure-alls, longing as we do to shed the weight of “hyperfrontal” consciousness.
Sacks himself has always been a strong presence in his work; a new if subtle aspect to that presence is his growing celebrity (his work has been rendered not only in a feature film-“Awakenings,” with Robin Williams in the doctor’s shoes-but as opera and play). This celebrity is, in part, what allows Sacks to shed his white coat, leave the ward and commune with extraordinary people like Bennett and Grandin, who might not have opened their lives to anyone else. The doctor’s hobnobbing even plays a climactic role in one narrative: While testifying before Congress on the value of music, he meets Mickey Hart, the Grateful Dead drummer, and so arranges to take Greg F., the amnesiac Deadhead, to a concert. At the end of the astonishing scene in which Sacks sits beside Greg in Madison Square Garden and sees him transformed by his passion, I cried for both: the patient exuberant with delusion; the doctor disappointed, ultimately, in his secret wish for a miracle.
These stories both contain and evoke much heartache. When the subjects are people who thrive in our world, we have the emotional leeway to laugh-for example, at Bennett’s hooting like an owl as he scrubs for surgery. But such light moments are rare. We rejoice that Grandin finds fulfillment through her empathy for animals, that she has learned to decode the behaviors of non-autistic people and so navigate society, but our feelings are far more complex when she takes us into her bedroom to demonstrate her “hug machine,” her stand-in for physical affection. Ultimately, we must recognize the voyeurism in our urge to look over Sacks’ shoulder-rubbernecking at accidents, fateful or genetic, that we have (so far) avoided.
Not that our motives are all unsavory. The more we listen to Sacks, the less we take for granted the millions of emotions, skills and impulses that make us what and who we are. Without exempting himself, he examines the false certainties that lead his profession astray and limit its scope of insight.
If we wonder what it would be like to have a child diagnosed as autistic, can we begin to imagine the pain of that diagnosis in the 1950s, when Leo Kanner’s theory of maternal fault was psychiatric law? Since then, the causes of autism have been identified as biological, and, as Sacks so crucially shows, the term applies not to a uniform “hopeless” disease but to a broad spectrum of deficits that in some individuals may be overcome, even brought to creative fruition, with the help of the right mentor.
As he so often does, Sacks invites hope where hope has been proscribed, an act that by itself makes this book priceless. He holds a mirror before humanity; in it are reflected strange, beautiful faces-and lessons-we will never forget.
