Tuesday, April 7, 2015

Oliver Sacks tributes



  1. Oliver Sacks, MD, the neurologist and best-selling author who wrote about the human spirit as much as the human brain, died today at the age of 82.

    The British-born author of Awakenings and The Man Who Mistook His Wife for a Hat announced in a New York Times op-ed piece in February that he had terminal liver cancer. The tributes that normally come after the funeral rolled in beforehand for Dr Sacks to appreciate. Sandeep Jauhar, MD, PhD, author of Doctored: The Disillusionment of an American Physician, said Dr Sacks demonstrated that it was possible to be both a physician and a writer, and that the two pursuits "could nourish each other."

    "Sacks wrote about his neurologically quirky characters with so much sincerity and humanity that he made you want to go anywhere with him, both in the literary sense but also in a personal sense," Dr Jauhar told Medscape Neurology earlier this year. "He seemed to be such a good, caring doctor and human being, the kind of person you'd want as a best friend."

    Jeffrey Lieberman, MD, the chair of psychiatry at Columbia University Medical Center, recalled Dr Sacks as a stout "gnome-like little man" with a twinkle in his eye whose clinical reports read like short stories. "Oliver was a uniquely gifted person with amazing observational and expressive talents," Dr Lieberman told Medscape Neurology.

    Dr. Sacks' final months were literary to the end. In April, his memoir, On the Move, was published. The cover features a photograph of a muscular young man in a leather jacket astride a motorcycle...

    "I had discovered my vocation, and this I pursued doggedly, single-mindedly, with little encouragement from my colleagues," he wrote. "Almost unconsciously, I became a story teller at a time when the medical narrative was almost extinct."...

    In his last published piece in the New York Times from 2 weeks ago, Dr Sacks took one final look in print at his life.

    "I find my thoughts drifting back to the Sabbath, the day of rest, the seventh day of the week," he wrote, "and perhaps the seventh day of one's life as well, when one can feel that one's work is done, and one may, in good conscience, rest."


  2. Although initially criticized by some in the medical establishment, Dr. Sacks was eventually recognized for his writing as much as his path-breaking work on conditions like autism. “He never allowed people to be defined by their deficits,” said Steve Silberman, the author of the recently published “NeuroTribes,” a book on autism for which Dr. Sacks wrote a foreword.

    “He had great respect for their special gifts and their humanity at a time when autistic people were regarded as less than fully human,” Mr. Silberman added.

    More recently, Dr. Sacks wrote personally revealing essays, including about his experiences experimenting with LSD and other drugs in the 1960s. In December, he completed a memoir, “On the Move,” days before he learned that he had metastatic cancer.

    “He was writing gorgeously at the end,” said Lawrence Weschler, a former colleague at the New Yorker and longtime friend. “The most amazing thing to me is the way in which he basically conducted a master class in how to die, after having conducted a master class in how to live and how to care and be a doctor.”

    Dr. Sacks was awarded the Lewis Thomas Prize for science writing in 2002. “Sacks presses us to follow him into uncharted regions of human experience—and compels us to realize, once there, that we are confronting only ourselves,” the accompanying citation said.

    In February, shortly after learning he had terminal cancer, Dr. Sacks wrote in an essay in the New York Times that he was swimming a mile a day and felt himself to be in robust health, but that his luck had run out. “This will involve audacity, clarity and plain speaking; trying to straighten my accounts with the world,” he wrote.


  3. And in what seems like a perfect triangulation of his life’s devotion to humanity, music, and beauty, his last tweet was an expression of appreciation for all three combined, a link to a video of one of the most stirring and divine flash mobs ever to have assembled, a street performance of Beethoven’s “Ode to Joy.” About the graceful, moving performance that begins with a single bass player and builds to a wall of symphonic and vocal sound, Sacks tweeted: “A beautiful way to perform one of the world’s great musical treasures.

    It’s a fitting signoff from the man who gave us Musicophilia and managed to distinguish human signals among the often baffling noise of our neurons. The video’s opening includes more than musical notes—the song is set against the backdrop of a busy plaza, with children crying, people talking, walking, laughing. And then, as the famous melody builds with each additional instrument and voice, all of the sensory systems that had been in their own worlds join one another in rapt, unified attention...

    If you’re reading this, you owe Sacks a debt of gratitude for his willingness to take time with people who were different, whose minds sometimes seemed out of reach, and his ability to make it possible for the rest of us to understand better. If you don’t need that understanding now, you will someday—for you or for a loved one...

    Sacks sometimes received criticism for his focus on cases instead of, say, developing diagnostic frameworks or systematic evaluation approaches. But anyone who engages with medical journals can tell you: The best parts are the case studies, the one that drill past cohort sizes or huge databases and march right up to the reader with the detail about one person, not just the case, but the human factor. They tell a real story and thus are irresistible, and no one told stories about the human brain better than Oliver Sacks did....

    In that profile, Silberman quotes a colleague of Sacks as saying: “The manner in which Oliver attends is the way in which he loves. The sustainedness of attention is what he does reverence with—and it’s what he gives to his patients."

    Sacks wrote the preface to Silberman’s NeuroTribes. In it, Sacks wrote about Silberman: “He thought about things and made connections."

    It’s something anyone could have written about Sacks himself. Of all the disciplines in medicine that involve direct patient interaction, neurology might have the coldest reputation, conjuring images of smart, superior, detached practitioners coolly observing their neurologically challenged patients, taking brisk notes, running through diagnostic algorithms.

    Sacks took notes, too. He observed, too. And he definitely thought about things. But the connection that he made, the bridge that gave millions of non-experts access to what he knew, was between the brain and the human heart. And whether you know it or not, you have reason to miss him.

    Courtesy of Doximity

  4. The day I met with Oliver Sacks, MD, he had had a “neuromusical morning,” as he described it, having served as a subject in his own experiment in Joy Hirsch's fMRI lab at Columbia University. He wanted to see if his brain showed contrasting changes when he listened to music (Schumann's “The Merry Peasant,” arranged for clarinet and piano by Joseph Horovitz, his composer cousin); when he replayed a familiar score in his mind (a Bach segment from an E major prelude); and when comparing a piece he liked (from Bach's “B minor mass”) and one he did not (from Beethoven's “Missa”).

    The experiment was being filmed for “NOVA” on PBS, but depending on the results, Dr. Sacks said, it might make a “nice little paper.” The 75-year old neurologist and prolific author has been writing those “nice little papers” as well as best-selling books for nearly five decades, demystifying and making into household words phenomena and conditions ranging from synesthesia to Tourette syndrome.

    Dr. Sacks' shyness may be legendary, but he struck me as a charming and gracious host. He has kept notebooks and journals depicting people, scenes, and events since age 12, and when he came here from England rather impulsively in 1960, he zigzagged across the country on a second-hand motorcycle for the nine months it took to get a green card, all the while chronicling his journey in a diary.

    He had always considered himself a “describer,” but it was not until he completed his neurology residency in 1965 that his writing came together in the form of patient stories. His dual roles as both physician and writer earned him an appointment in 2007 as Columbia University's first Columbia Artist; this spring he is teaching a graduate course on case history in science writing on one campus, and he sees patients in the movement disorders clinic in his position as professor of neurology and psychiatry at the medical center.

    Dr. Sacks now uses hearing aids (confessing to often mishearing words as obscenities), and melanoma has taken vision from one eye, making it difficult for him to read more than a page at a time. He suffers from arthritis, perhaps accelerated by a stint as a weight-lifting champion, and consequently prefers to write using oversized pens. But the maladies are belied by an ever-present enthusiasm, as he leaps up from his seat in a show-and-tell of photos, essays, and books.

    His West Village office is cluttered with journals, tablets of yellow paper he prefers for typing, and piles of folders and correspondence. He has a bookcase devoted to schizophrenia and a table to Darwin, two upcoming projects. Recently, his apartment in the building next door had pots of earthworms (in preparation for a Darwin article) because when planning to write, he says he can't get into anything in a purely literary way. In an interview with Neurology Today, Dr. Sacks described his process of writing, his lost book, his next book, and how his role as a neurologist sparks his creative work.


  5. Of course that wasn’t the first time he had gone out of his way for a patient. When a blind, paralyzed, terminally ill patient learned Dr. Sacks was an avid motorbiker, she expressed a wish to take one last ride with him along the twisties of Topanga Canyon (Cali 27). Dr. Sacks arrived one fine Sunday with 3 heavy bikers who all carried the patient out to Dr. Sacks’ bike and securely tied her in place to him and his bike. She loved the ride. Dr. Sacks was almost fired as a result for being “unprofessional” and “disruptive” but was saved by the patient’s staunch support.

    That he was almost fired tells us all we need to know about those who occupy the higher rungs in medicine.

    It wasn’t any better after he awakened the catatonic. “Professional” doctors from the big teaching hospitals, who had all condemned the patients as beneath their time, “publicly roasted” Dr. Sacks for proving they were uncaring wastes of space.

    Things have gotten a million times worse thanks to Harvard’s Dr. Lucian Leape who has relentlessly campaigned against the likes of Dr. Sacks and through the American Medical Students Association has ensured future generations of American doctors will not be like Dr. Sacks.

    Dr. Sacks represented everything Dr. Leape loathes and defames as “disruptive” – he cared totally about the individual patient, their lives, hopes, dreams, and humanity.

    Unlike Dr. Leape, Dr. Sacks did not sit around telling other doctors that they killed 100,000 patients every year and that they needed to purchase expert consultancy from his LeapFrog Group.

    Instead, he devoted his life to his patients and to reminding the general public that neurological patients were as human as us all, and sometimes a bit special. He loved it when they survived their deficits or excesses and thrived.

    Never ever did Dr. Sacks look upon patients as a number or a means to an end, a stone upon which to step to falsely boost one’s “career.”...

    After all, it is always the cold ambitious sociopathic fraud who climbs the ladder and receives the accolades, awards, research grants and gushing write-ups in the Globe. The kind that Ben Hecht termed “The Respectables.”

    Dr. Sacks, as expected, had only 20 published papers to his name and none of the long list of awards “the Respectables” give each other. Other members of “The Respectables” did not fall over themselves to laud him to the stars.