Oliver Sacks's not quite nonfiction

0:00Support for this show comes from Odoo. Running a business is hard enough, so why make it harder with a dozen different apps that don't talk to each other? Introducing Odoo. It's the only business software you'll ever need. It's an all-in-one, fully integrated platform that makes your work easier. CRM, accounting, inventory, e-commerce, and more. And the best part? Odoo replaces multiple expensive platforms for a fraction of the cost. That's why over thousands of businesses have made the switch. So why not you? Try Odoo for free at odoo.com. That's O-D-O-O dot com. When I scraped my car in that parking garage, I was worried that it could be a long process to take care of it.

0:45Like a landscaper's first day trimming a hedgeman. I have definitely already been here. Now, was it left, right, or right, left? Well, maybe I'll cut a path out and find my way back later. But it wasn't like that. I filed a claim in under two minutes on the Geico app, and they handled it from there. It was taken care of almost as quickly as it happened. It feels good to get help quick. It feels good to Geico. I recently sat down with one of my favorite writers. I'm Rachel Aviv, and I'm a staff writer at The New Yorker. But I called her up to talk about a different writer. I think I remember the first story I pitched for The New Yorker.

1:26I tried to make it clear, don't worry, I'm not trying to do an Oliver Sacks piece because I didn't want them to think that I was daring to compete. I really admired his ability to just delve deeply into the inner life of one person. The late neurologist and bestselling author, Oliver Sacks. He's been And referred to as the poet laureate of medicine. It was sort of like almost the figurehead for medical humanities in a way. Like this idea that we have been focusing too much on symptoms and data. And that there is a human life behind all of this information. Oliver Sacks did something kind of wild for his time.

2:09He was a medical doctor who wrote intricate stories about the inner lives of his own patients. I do remember being in my early 20s reading a piece he'd written about a man who was blind and was sort of grappling with the possibility of regaining his sight. I loved how he was focused on one person, sort of one person's journey. He was so focused on the inner life of this person and that it was so textured. Kind of like, how did he know those details? How did he know that that man was thinking that? Maybe the best example of one of these stories is from the book Awakenings, which he published in the early 1970s.

2:52He writes about spending 15-hour days at a hospital with a group of patients suffering from a disease called encephalitis lethargica, a sickness that left them catatonic, basically asleep while awake. Patients that no other doctors were really paying attention to and kind of developing a wordless rapport with people that were really easy to dismiss as sort of not fully cognizant. And he spent so much time with them that he was able to sort of detect that they were not like comatose in the way that other people thought they were. That book was adapted for the screen and became an Academy Award nominated film.

3:36It starred Robert De Niro as a patient named Leonard and Robin Williams, who played a fictional Oliver Sacks. Towards the end of the movie, he gives a speech about the awakening of the human spirit.

3:49Rachel Aviv:That the human spirit is more powerful than any drug. And that is what needs to be nourished. with work, play, friendship, family. These are the things that matter.

4:14Rachel Aviv:This is what we've forgotten.

4:21The simplest things. Basically, he meant human connection. could somehow awaken the spirit beyond medical care alone. Late last year, Rachel wrote a huge magazine story about Oliver Sacks for The New Yorker. I became aware that Oliver Sacks had this enormous archive. An archive of diaries and letters that Sacks had kept over decades. He documented not just the lives of other patients, but his own experience as a patient in therapy. Rachel got in touch with his foundation and got permission to take a look. I was like, how is this possible that this amazing man was in therapy for 50 years? Like, what does a half-century psychoanalytic process look like?

5:15I was just like, this man is so articulate about other people's psychic lives. of what is happening in the therapeutic process and how much can someone change in 50 years of therapy? Like, how far does self-knowledge go? Today, we're going to follow Rachel Leviev's journey through the life of one of the most famous science writers of our time, a profile of a man known for his truth-telling in medicine, who Rachel discovered bent the truth. In his journals, he would just sort of reflect on what he had done and try to make sense of it, And he would sort of think through, like, art is the lie that tells the truth.

5:53Am I doing art or have I crossed a line? I'm Amy Padula. This is Unexplainable.

6:14so for all of oliver sax's writing about the super intimate details about the lives of patients he didn't share much about his own life with the public for most of his career In a 2002 interview, he said that his severe shyness, which he described as a disease, had been a lifelong impediment to his personal relationships. And for most of his life, he lived alone. What were some of the most surprising anecdotes or sort of things you learned about what was going on for him in his personal life? One of the most amazing sets of correspondence that I read was Sachs' letters to this man who lived in Berlin at the time.

7:01And they had met in Europe. They'd had this, like, whirlwind romance. And then Sachs moved to New York. After a couple weeks, Sachs went back home to New York City. And the two start writing to each other. and then their entire sort of affair took place in these letters and they were just like thrilling letters each one it was like sax was trying to outdo himself to find new expressions of like the intensity of his love and his sense that he was merging with this man and that for the first time in his life he felt at peace with being a gay man he was seeing the world through new eyes Sacks wrote about these intense feelings.

7:44There's a line that describes his happiness. I wonder if you could recall it. My blood is like champagne. And then two weeks passed in which he didn't get a letter from this man. And suddenly, like, all of Sacks' kind of euphoria turned in on him. And he started to think, like, I was delusional. Like, I was part of a two-man delusion. Like, this was never love. I'm always going to be alone. And I always have. The man eventually wrote to apologize, but for Sacks, the damage was done. And he was like, yeah, this is the truth. I will be in a spiritual cell for my entire life. And he finally just completely cut off the relationship with this man and then began to feel suicidal, which led to him beginning therapy for the next 50 years.

8:35After that early relationship, Sacks suffered. He couldn't make friends. He couldn't connect with people. He became celibate and wrote obsessively. Some of his correspondence with other gay men in the 50s and 60s and 70s and even 80s, like the sort of anguished state of being a gay man at that time. I think it's easy to almost forget how excruciating it was then. And so many of the people he was corresponding with, they would be like testing the waters to see if they could reveal to the other one that they were gay. There was so much sort of self-hate and sort of tortured conversation around it 30, 40 years ago.

9:20Felt really alive in his letters as well as his journals. Just the sense of like self-punishing, self-hiding experiences. I could see how he was sort of expressing a feeling of stuckness in life. Was there a moment in the reporting where you started to realize that his personal life was seeping into the work? So I had read many of his letters. I went back and I did a lot of rereading because it was like the first time I read everything, I didn't know what I was looking for. And then there would be times like at one point I was rereading Awakenings. And I remember reading one of the patients describing her blood as being like champagne, which was striking because I, you know, that's the phrase he'd used in his letters.

10:06to this lover from Berlin. So there were just these kinds of, it was almost like rhymes between his own descriptions of himself and his descriptions of his patients. One of the most striking rhymes that she found had to do with a particular poem by Rilke. The poem is about a panther who feels trapped, caged. Where had you seen that poem before? It was in his letters to describe how he felt when he was trying to write his first book about migraines. And I just remembered that phrase. And then I searched through my notes and I saw another reference where he had also used that phrase in a letter to his therapist.

10:46So it was clearly an important poem for him in his own self-conceptualization in these moments of crisis. The poem evoked something similar to the way Sachs was feeling in his journals. About not being able to express his sexuality and his personal life. Not being able to connect. And then I was reading Awakenings, and I was reading the chapter about Leonard, who's sort of the star of the book. Leonard, played by Robert De Niro in the movie adaptation, suffers from a sleeping sickness. He lives in a sort of trance-like state. Sachs gave patients like Leonard a drug called L-Dopa, which changes the brain's dopamine levels.

11:27In his book, Awakenings, Sachs writes that Leonard would spell out answers to questions that Sachs asked him because he couldn't speak. I just noticed that he said that Leonard typed out on this, like, typing board that he felt like the Panther in Rilke's poem. In the movie adaptation, Robin Williams, as Oliver Sachs, reads that poem.

11:51Rachel Aviv:His gaze, from staring through the bars, has grown so weary that it can take in nothing more. For him, it is as though there were a thousand bars and behind the thousand bars, no world. As he paces in cramped circles over and over. I thought like, that's a strange coincidence that his patient would happen to sort of cite this poem that had been so meaningful to Sachs. And then I became kind of more attentive to those moments. What was going through your mind as you saw these rhymes, as you put it, play out? Was there any betrayal you felt as a reader seeing this kind of like appear in the records?

12:43Yeah, I mean, I think that made me feel like, okay, well, I can't trust that any particular detail is true. Did Oliver Sacks know he was fabricating things? Yeah. It was really reading the journals after I had been reading them for a couple months when I just read a passage where he straight out says, you know, I feel like so, I can't remember the exact phrasing, that he's feeling this sense of criminality and that he feels so guilty for making things up. I would say that a man who mistook his wife for a hat had a lot of fabrications in it. And that book then made him extremely famous. And I think he felt a lot, like much of the guilt that he expresses in his journals is about that particular book.

13:28But like the strange thing is when that book was about to be published, he wrote his brother and said, like, you might call these confabulations. They're sort of half story, half fable, half made up. He was pretty open about the status. So I don't know what happened in the publishing process. Somehow these were taken as like case studies that were supposed to be straight fact. And he seemed pretty clear early on that that's not what they were, at least to himself. But suddenly it became like wildly famous and he became this huge figure. Sachs himself says like this was my most flagrant fabrication.

14:05And it involved these two twins who had autism, who were institutionalized. And Sachs said that they were like exchanging prime numbers up to, I think, 20 digits. And that finding got a lot of attention because like no one had known this to be a human capacity. And so psychologists and mathematicians had written about this with some really defending the importance of this finding. And so that felt really like a space where a case study had actually had an impact on people's understanding of human capacities. So I think I tend to agree with Sachs that that was the most flagrant moment or transgression.

14:51Rachel's magazine story came out in December of last year. And it got people talking. I did see people on the internet, like, putting their own headlines on the piece and sort of making it all about, you know, he fabricated. That kind of felt sad to me because that didn't feel like, if I wanted it to be more complicated than just, oh, let's dismiss Oliver Sacks, he was making stuff up. We'll be back after a short break.

15:24Support for the show comes from Quince. I'm often on quests for weirdly specific basic clothing staples. So like, sometimes I want a really nice long-sleeve black shirt that just kind of fits in a certain way so that I can layer it under one of my sleeveless dresses. Or other times I want a nice short-sleeve black shirt that looks a certain way with my favorite pair of jeans. And what I really appreciated about Quince is that they had a whole range of different shirts for me to choose from. I wound up getting three different ones, each with variations in neckline and sleeves and material. And they were all pretty much exactly what I was hoping for.

16:06Now, you might not be looking for several different kinds of hyper-specific black shirts, but Gwintz also has lots of wardrobe staples for spring for you to choose from. Think 100 % European linen shorts and shirts from$34 that are lightweight, breathable and comfortable, but still look put together. You can refresh your wardrobe with Quince. Go to quince.com slash unexplainable for free shipping on your order and 365 day returns now available in Canada too. That is q-u-i-n-c-e dot com slash unexplainable to get free shipping and 365 day returns. Quince.com slash unexplainable.

17:14row. Futurology isn't sci-fi. Each week, they have thoughtful conversations with scientists, artists, technologists, philosophers, people who illuminate the forces shaping our lives and try to imagine both where they'll take us and also how we can respond. They discuss whether the future is something we have to endure or something we can design. And if we can design it, what will we built. Subscribe to Futurology wherever you get your podcasts or watch full episodes on YouTube.

18:11CRM, accounting, inventory, e-commerce, and more. And the best part? Odoo replaces multiple expensive platforms for a fraction of the cost. That's why over thousands of businesses have made the switch. So why not you? Try Odoo for free at odoo.com. That's O-D-O-O dot com.

18:36Is this Karen Eiffel? Yes. My name is Harold Crick. I believe you're writing a story about me. You talked about how some of the comments that you saw in your piece, the sort of TLDR headline, Saks fabricated stuff, which is true, but you also said that was frustrating. And I'm wondering why. Something interesting happened where I couldn't like tell you quite who or what, but I felt like there was a contingent of like anti-science people on social media. It almost was like, oh, look, this sort of liberal darling of science fabricated things like science is a sham. I guess I also just felt like the takeaway of my story, I did not want it to be just, oh my God, let's like throw Saks out the window.

19:29He fabricated things. And so that seemed like there was some of that going on. And I was sad about that. But like, it's within this like much larger context of like one man's sort of struggle, you know, during the time when he was fabricating a lot of other sort of literary stars were doing similar things. So it's also within a historical context. But yeah, I think there are moments in which, to me, it was almost the projection that was most striking, like taking phrases that he used to describe his own angst and sort of putting it onto his patients. I guess I wanted to think about how those fabrications or those sort of exaggerations feel revealing of dynamics in the way we respond to this kind of writing, in the way that other people respond to it, in the kind of expectations we have for like what empathy as a writer looks I think it's more about this genre of writing that he inspired, this sort of telling tales about illness that are kind of supposed to inspire or show you the secret gift of your illness.

20:44I think, like, if anything, I would want it to inspire, like, more kind of thinking about the relationship between, like, a writer and a subject, and particularly a sort of doctor and the patient subject, and how much of ourselves we bring onto that encounter, sometimes without realizing it, sometimes. Do you know how any of his patients felt about his rendering of them? Leonard's family loved him. They didn't necessarily think the book was all accurate, but they were just so grateful for the time and the care that he had put into that relationship. Like, the families that Leonard and his mother just adored him.

21:29And the other patients I talked to as well really adored him. They didn't fundamentally care, you know, about how they were written about in this book. What they cared about was that there was this doctor who was like sitting with them for hours, trying to understand them and making them feel, you know, like that they were someone who had a story to tell. A huge part of Sax's life that Rachel's story eliminates was his ongoing struggle with his sexuality. After that early relationship in Berlin, he lived unhappily closeted and celibate for decades. You unpack some of his battles in therapy and how some of that was getting worked out in the writing.

22:08At one point in the piece, you suggest that Sack spent much of his life searching for love. He once wrote, we spend our lives searching for what we have lost, and one day perhaps we will suddenly find it. I just wonder what you make of that as you were sort of seeing these patterns crop up in the work. I mean, that idea that in therapy you're like working through, I like that phrase, working through. Because I think, like, probably most writers choose subjects to some degree because they're working through ideas that are, like, important or problematic to them. And then they sort of displace it onto these other subjects where they're working through.

22:48And it felt like he was like rehearsing this narrative, which was someone who is trapped in this cell, this sort of spiritual cell, this sense of being in a cage, suddenly is kind of released and has this awakening. And many of his stories have that arc. And so then it was striking to see, I mean, it was almost like the longed-for outcome that he keeps sort of playing out in his work. Do you think about what you do as a reporter any differently after learning about sort of how Sachs identified with his subjects? Do you think differently about what you do at all? I think it was like part of a like a longer conversation with myself as I age as a writer my curiosities change and my identifications change and so therefore like when I'm writing a story about a family for instance like I'm going to I might actually change the kinds of questions I'm looking at because of where I am in life.

24:01or I find that I'm often like writing about people with complicated relationships to work. And that's because I'm, there's a question I have about my own relationship to work or, so yes, I think like writing is always a kind of working through. And in a way, I think that if it's not a working through, it's less rich. Like if you're writing about something about which you have no sort of unsettled questions and curiosities, then the writing can be flatter for it. So I think you do want some of that kind of like identification and projection energy, but it can be taken way too far and too far in unethical ways and in really problematic ways.

24:42So it feels like a subject that does have stakes in my life and in sort of any kind of writing. He was a physician treating them and a writer observing them. And I wonder if anything came up for you in terms of like that split role. Yeah, I mean, I think there was some like problematic like R.D. Lang type stuff going on where like R.D. Lang is the psychiatrist who kind of wanted his patients with psychosis to like, it was almost like he was bringing their psychosis to full fruition so that he could gain more insights about the nature of madness. and Sacks actually writes about that too, that kind of guilt that like some of his patients with Tourette's syndrome, he would like want their tics to reach, sort of tick as, to become floridly symptomatic essentially because he felt like in that process, he as the writer and the researcher was sort of gaining more insight into the nature of the disease.

25:45And I think he like told himself that that could be good for the patient while also sort of realizing it was fundamentally like, you know, helping his project. After he had become famous for books like Awakenings and The Man Who Mistook His Wife for a Hat, Sachs did this interview in 1989 with a reporter from PBS. A hundred years from now, how would you like to be remembered? I would like it to be thought that I had listened carefully to what patients and others had told me, that I'd tried to imagine what it was like for them, and that I'd try to convey this. And to use a biblical term, the feeling, he bore witness.

26:34I think, like, bearing witness in medicine has come to mean, like, Like you are sort of present in someone's moment of a suffering to allow them to feel that they are seen and they are heard and that they're not alone. And that you're kind of like doing this thing where you're not turning away. Like other people, it's just too hard. This idea of bearing witness is very kind of central in medical humanities. but I don't know that you can also you can bear witness and also like write a story about someone those are two very different acts and I think Sacks was sort of merging them both and presenting a model of how both can be merged and there's a lot of like self-interest involved or not self-interest but sort of you have like a your mind is doing calculating things when you're thinking about how someone becomes a story.

27:32And when you're bearing witness, I think you need to be blank in a way that you probably can't be as sort of an authorial imagination. Sacks said he wanted to be remembered as someone who bore witness. And I get that, but I also think that it is very hard to do that when you're telling a sort of magical fable about someone's illness and sort of the gifts that it might have bestowed upon them. What I find so fascinating about this story is that there's Oliver Sacks the doctor and Oliver Sacks the writer and Oliver Sacks the man. And what happens when all of those versions of Sacks collide into each other?

28:22I think anyone would kind of say that one of the genius things he did was to see all these patients who were in, like, comatose states, and other doctors had dismissed them, and he saw something in them. Like, he felt a sense of identification. Because he also saw himself as, like, the living dead and someone who'd been buried alive, these were words that he used, I think he was capable of imagining that there was, like, a real person. There was, like, a real consciousness, a real lively intelligence, like sucked away by this illness inside these people. And so he spent enough time with them to realize that that was true.