Why Oliver Sacks is One of the Great Modern Adventurers- page 2 | Science | Smithsonian
Dr. Oliver Sacks dives deep into the brain to find the greatest adventures. (Leonardo Cendamo)

Why Oliver Sacks is One of the Great Modern Adventurers

The neurologist’s latest investigations of the mind explore the mystery of hallucinations – including his own

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In case you don’t recall the astonishing events that made Sacks the subject of the Oscar-winning film Awakenings, they began when he found himself treating chronic psychiatric patients in a dusty and neglected hospital in the Bronx (Robin Williams played him in the film; Robert De Niro played one of his patients). Dozens of his patients had been living in suspended animation for decades as the result of the strange and devastating aftereffects of the encephalitis lethargica (“sleeping sickness”) epidemic that raged through the ’20s, which had frozen them in time, semiconscious, mostly paralyzed and virtually unable to respond to the outside world.

It was grimly horrifying. But Sacks had an idea, based on his reading of an obscure neurophysiology paper. He injected his patients with doses of L-dopa (which converts into dopamine, a primary neurotransmitter), and a veritable miracle ensued: They began to come alive, to awaken into life utterly unaware in most cases that decades had passed, now suddenly hungry for the life they’d lost. He’d resurrected the dead! Many moments of joy and wonder followed.

And then disturbing things began to happen. The dopamine’s effectiveness seemed to wear off in some cases. New troubling, unpredictable symptoms afflicted those who didn’t go back to “sleep.” And the patients experienced the doubly tragic loss of what they had all too briefly regained. What a doctor’s dilemma! What a tremendous burden Sacks bore in making decisions about whether he was helping or perhaps further damaging these poor souls whose brains he virtually held in his hands. How could he have known some of the miraculous awakenings would turn into nightmares?

I must admit that I’ve always felt a little fearful just contemplating Sacks’ books. The panoply of things that can go frighteningly wrong with the brain makes you feel you are just one dodgy neuron away from appearing in Sacks’ next book.

I felt a certain kind of comfort, however, in talking to him in his consultation room. I wasn’t seeing things, but who knows, should anything go wrong, this was the place to be. There was something soothingly therapeutic about the surroundings—and his presence. I didn’t want to leave for the hallucinated reality of the outside world.

The book Hallucinations in particular gives one a sense of the fragile tenuousness of consensus reality, and the sense that some mysterious stranger hidden within the recesses of your cortex might take over the task of assembling “reality” for you in a way not remotely recognizable. Who is that stranger? Or are you the stranger in disguise?

It sounds mystical but Sacks claims he has turned against mysticism for the wonder of the ordinary: “A friend of mine, a philosopher, said, ‘Well, why do all you neurologists and neuroscientists go mystical in your old age?’ I said I thought I was going in the opposite direction. I mean I find mystery enough and wonder enough in the natural world and the so-called ‘order experience,’ which seems to me to be quite extra ordinary.”

“Consensus reality is this amazing achievement, isn’t it?” I ask Sacks. “I mean that we share the same perceptions of the world.”

“Absolutely,” he replies. “We think we may be given the scene in front of you, the sort of color, movement, detail and meaning, but it’s an enormous—a hell of a—marvel of analysis and synthesis [to recreate the world accurately within our mind], which can break down at any point.”

“So how do we know consensus reality bears any relationship to reality-reality?” I ask him.

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