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Nonfiction

Oliver Sacks’s Final, Posthumous Work

Oliver Sacks at home, March 2015.Credit...Bill Hayes

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EVERYTHING IN ITS PLACE
First Loves and Last Tales
By Oliver Sacks

The word “Oneirism” is more than just an obscure exception to the “i” before “e” rhymelet. It also exemplifies the exceptionally advanced and sometimes stymying lexical breadth of Oliver Sacks’s writing — never more challenging than in this last, posthumous book, a collection of previously uncollected and/or unpublished essays. (“Oneiric,” in case you were wondering, means “related to dreams or dreaming.”) The book’s many other linguistic rarities include “festination,” “bradykinesia,” “metanoia,” “achromatopsia.” Occasionally Sacks pauses for a definition. More often he doesn’t.

This is a good thing. Many of these words are specific to Sacks’s medical specialty, neurology, as chronicled in his often best-selling books (“The Man Who Mistook His Wife for a Hat,” “A Leg to Stand On,” “Awakenings,” this last adapted into a film). Their meanings could have been spelled out, perhaps, but often only with condescendingly grade-school diction. In other words, this obscure terminology serves to honor the reader. If you don’t know our meanings, these terms imply, trust us that we are carefully chosen, as we trust you to look us up.

“Everything in Its Place”: a lame title. Especially since the topics here are actually a wonderfully odd lot, despite the worthy effort to group them into sections — “First Loves,” “Clinical Tales” and “Life Continues.” Why not name the whole book after its essay “Anybody Out There?,” about the possibility of extraterrestrial life (“It is not clear whether life has to ‘advance,’ whether evolution must take place”). Or after “Summer of Madness,” an account of the thrilling but dangerous euphoria of a young woman named Sally who, in the manic stage of her manic depression, “breaks.” After haranguing strangers in the street, shaking them, demanding their attention, she suddenly runs headlong into a stream of traffic, convinced that she can bring it to a halt by sheer willpower.

As it happens, this essay provides Sacks the chance to address a truly serious literary issue — one that troubled Sally’s father, Michael Greenberg, as he considered writing about his daughter’s illness. (He finally did, more than a decade after this onset of her mania, in an excellent, unflinching memoir called “Hurry Down Sunshine.”) It troubles Sacks, too: “The question of ‘telling,’ of publishing detailed accounts of patients’ lives, their vulnerabilities, their illness, is a matter of great moral delicacy, fraught with perils and pitfalls of every sort.”

This ethical dilemma is of concern for most if not all writers of medical and psychiatric case-study books, both physicians and laypersons. In fact, there exists now an extensive literature on the subject, including a 2017 HopkinsMedicine article called “The Right to Write About Patients,” by Dr. Benjamin Oldfield and Lauren Small (an expert in the field of narrative medicine). In a more recent, widely cited piece in The Huffington Post, Dr. Danielle Ofri asked, “Doctor-Writers: What Are the Ethics?”

Sacks has occasionally fallen victim to such moral criticism of his own writing. He was called “the man who mistook his patients for a literary career” by the British academic and disability rights activist Tom Shakespeare. The author G. Thomas Couser cites the journalist Alexander Cockburn as having characterized Sacks’s work as (in Couser’s words) “a highbrow freak show that invites its audience to gawk at human oddities.”

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But there is an argument being made now that our increasing appetite for stories about the human element in medicine and science proceeds, at least in part, from the erosion of mythology and religion as convincing schemas for understanding the human condition. This suggests that there may be something bardic about these modern writers/doctors — Sacks, Ofri, Atul Gawande, Daniel Kahneman, James Gleick, Jerome Groopman, Abraham Verghese, Rebecca Skloot, even Mary Roach. They are searching for meaning and coherence within particular lives touched by random afflictions and the dizzying advances in science, rather than in any form of divine providence. As Sacks himself has said, “I would hope that a reading of what I write shows respect and appreciation, not any wish to expose or exhibit for the thrill ... but it’s a delicate business.”

Like all performers, those of us who write for an audience do so for three main reasons — two of them noble, the third a little darker: 1. To share information and narratives that will interest, enlighten, move, entertain readers; 2. To help create, out of silence and solitude, a community or communities of people drawn to this information and these narratives; 3. Usually on an unconscious level, to gain for ourselves attention and admiration from strangers — generally as anonymous stand-ins for parents who we think in one way or another failed to adequately recognize our specialness.

So, yes, Oliver Sacks’s writing, like any writing, partakes in showboating, even when cloaked in modesty and self-effacement. More to the point, though, the people he writes about, here and elsewhere, do often suffer from what “normal” people might think of as one kind of peculiarity (maybe even freakishness) or another. Even in the first, mainly autobiographical section of the book, Sacks records his own early idiosyncratic passions with a straight face that may be an attempt to normalize his own budding obsessions — among them long-distance and endurance swimming and weight-lifting. The first essay, “Water Babies,” recounts the Sacks family’s penchant for swimming. Sacks recalls that he “was named Top Distance Swimmer at the Mount Vernon Y, in Westchester: I swam 500 lengths — six miles — in the contest and would have continued, but the judges said, ‘Enough! Please go home.’”

As a schoolboy, Sacks spent three weeks in Millport, Scotland, studying marine biology. There he became preoccupied with cuttlefish, collecting them from the fishermen who had no use for them. He stored them in buckets of salt water and alcohol — not enough alcohol, as it turned out — in the basement of a friend’s temporarily empty summer house, for subsequent experimentation. “A few days later,” he writes, “we heard dull thuds emanating from the basement, and going down to investigate, we encountered a grotesque scene: The cuttlefish, insufficiently preserved, had putrefied and fermented, and the gases produced had exploded the jars and blown great lumps of cuttlefish all over the walls and floor; there were even shreds of cuttlefish stuck to the ceiling.”

Explosions — and stuckness — of different, neurological sorts went on to fascinate Sacks throughout his career. In the “Clinical Tales” section, an essay called “Travels With Lowell” tells of visiting La Crete, a Mennonite community in Canada populated by Touretters of many intensities and variations. On the other hand, in “Cold Storage,” thyroid injections bring back to active life a patient named “Uncle Toby,” who has been “suspended … in some strange icy stupor,” his body temperature 30 degrees below the human average, for seven years.

In the book’s final section, Sacks’s lens expands from memoir and clinical tales to a helter-skeltering of topics: life on other planets; his love of herring (“Clupeophilia”); searching for ferns that burst through the meager soil on the railroad abutments on Park Avenue.

Life bursts through all of Oliver Sacks’s writing. He was and will remain a brilliant singularity. It’s hard to call to mind one dull passage in his work — one dull sentence, for that matter. At the end of this book, and very near the end of his life, in “Filter Fish,” he even manages to give gefilte fish, of all things, a wonderful star turn: “In what are (barring a miracle) my last weeks of life — so queasy that I am averse to almost every food and have difficulty swallowing … I have rediscovered the joys of gefilte fish. … Gefilte fish will usher me out of this life, as it ushered me into it, 82 years ago.”

A correction was made on 
May 1, 2019

An earlier version of this review misidentified a writer who held a negative opinion of Oliver Sacks’s work. He was Alexander Cockburn, not G. Thomas Couser.

How we handle corrections

Daniel Menaker, the former fiction editor at The New Yorker and former editor in chief of Random House, is the author of seven books.

EVERYTHING IN ITS PLACE
First Loves and Last Tales
By Oliver Sacks
274 pp. Alfred A. Knopf. $26.95

A version of this article appears in print on  , Page 14 of the Sunday Book Review with the headline: Neurologist and Wordsmith. Order Reprints | Today’s Paper | Subscribe

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