"I regard myself as a subject," Oliver Sacks says.
Sitting in his comfortable, light-filled office, its several rooms overlooking a green pocket park in Manhattan's West Village, Sacks talks about how that approach became a part of his new book, Hallucinations.
Perception — how our brains receive and process information about the world around us — has long been a major theme in Sacks' work. A professor of neurology at the New York University School of Medicine, Sacks, 79, has written several bestselling books, including The Man Who Mistook His Wife for a Hat, An Anthropologist on Mars, Musicophilia and Awakenings, which was made into an Oscar-nominated movie. His 2009 TED talk on hallucinations has been viewed more than 1.4 million times on the Internet.
Reaching into a box on his desk, Sacks couldn't resist a little experiment in perception with me when I interviewed him in June. "Put your hands out," he says softly, holding two cylinders of metal, one charcoal dark, one silvery, both the same size. He drops the dark one, and it's improbably heavy, almost tumbling to the floor; the other is so light it hardly registers. "Tungsten, aluminum," he says with a delighted giggle.
Hallucinations recounts some more complex, and sometimes risky, experiments. Much of the book is drawn from meticulous case histories of patients Sacks has kept over the years. (He has treated thousands but sees only a few these days.)
He says, "The implicit aim of the book was to show that hallucinations don't mean schizophrenia," a subject he plans to write about in another book, all or even most of the time. "Many of them are benign. They don't have to be terrifying; they're almost a normal phenomenon."
Sacks begins the book with a description of Charles Bonnet syndrome. Named for the 18th century Swiss naturalist who first described it, the syndrome is marked by vivid, detailed visual hallucinations and occurs mostly in people who are blind or visually impaired. The movielike images, which can go on for long periods of time, are not usually frightening — in fact, patients with the syndrome often enjoy them. One described them as a gift from "the angel of hallucinations."
The book covers auditory and olfactory hallucinations, visions of departed loved ones, out-of-body experiences, hallucinations associated with Parkinson's and narcolepsy.
"At the last second I added a chapter about evangelicals," Sacks says. "I became fascinated with the kind of prayer that has such extreme concreteness and vivid detail that it leaps over from imagination to hallucination. It's parallel in some ways to some forms of meditation, in that it's using physiology and imagery to get into a different state of mind."
In some chapters, Sacks writes about his own experiences with hallucinations. Some are involuntary — a migraine sufferer since childhood, he's familiar with the aura that can signal or accompany the headaches, which may include several kinds of hallucinations.
In a chapter titled "Altered States," he writes about his intentional pursuit of hallucinatory experiences while he was a medical student in California in the 1960s. (He notes that he experimented on weekends, not while he was working.) They include his self-experiments with marijuana, LSD, morning glory seeds, amphetamines, opium and a synthetic drug called Artane, which produced hallucinations so vivid — and mundane — he was entirely fooled by them. His withdrawal from a long stint of taking chloral hydrate as a sleep aid left him with such a horrible case of delirium tremens he feared he had suffered a psychotic break.
"My chemical days," Sacks says of that period. "I had learned from textbooks, but I wanted to be able to give firsthand accounts."
Telling stories, his own and other people's, has always been an obsession, Sacks says. "I felt split in my early twenties between being a writer or a scientist. Medicine as such came relatively late for me. I practically had to be dragged to medical school."
Among his inspirations, he says, are the two great Charleses of the Victorian age, Darwin and Dickens. "They were speaking to everyone" in their hugely influential writing.
Sacks has managed to combine his passions, pursuing both science and storytelling. He writes constantly (using a fountain pen), not only his books and articles but personal journals that he has kept since age 14. "There are about 600 of them," he says, motioning to several shelves of the journals in the office.
Sacks says that one other form of writing, the extensive case notes he has always made on his patients, has been "crucial" to his books, and he decries modern methods that reduce that notekeeping to formulated diagnoses. In Hallucinations, he says, "I take a slap at the DSM," the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.
He has taught classes on narrative writing about medicine, and he tells students, "You mustn't make things up. But you're not called on to exclude pathos or human despair."
"With medicine," he says, "you're talking about the human predicament."
Colette Bancroft can be reached at firstname.lastname@example.org or (727) 893-8435.