I spent an hour tonight rummaging around the Boston Public Library website. I was trying to get them to give me a reprint of a 19th century book on migraines by a long-dead neurologist, in a specific 1997 edition that has a foreword by a slightly-less-long-dead neurologist. Strictly because I have a massive brain-crush on the late neurologist of the foreword, and he had a massive brain-crush on the late-late neurologist who wrote the original book.

If any of you were wondering where all of the randomness of this blog comes from, you got me. It's from the depths of the rat's nest that is my brain. If any of you were wondering how I got my writing style, that's much easier. I had a few very large influences when I was a wee babby scribbler, and one of them was the neurologist Oliver Sacks.

There is this persistent idea that intellectual brilliance and social competence are a zero-sum game. If you had asked Sacks, he'd be the first to claim he had fallen victim to it. He considered himself awkward, and he was certainly something of an odd duck. He was absent-minded, prosopagnostic to the point where it spilled over into other categories like 'landmarks' and 'objects' and 'finding his own house on the walk home', and had a penchant for forgetting ANSI-standard manners when presented with an interesting case or a prehistoric fern. Still, he must have had a sort of earnest charm, because his books are full of instances of him writing to the foremost authority on whatever strange disease he had fixated on at the time, politely introducing himself, and asking if they would like to explain everything they knew at interminable length on the plane to a tiny island in Micronesia, where the biggest known cluster of it was. Quite a lot of them said yes.

Sacks felt all the vicissitudes of neurological disorders at least as acutely as his patients. He spoke occasionally about his early life, and whenever he mentioned his father, a general practitioner, it was always with great warmth and admiration for the relationships he had with his patients. Sacks did a great deal of moving around and riding motorcycles and taking drugs and weightlifting and other things as a young adult, which I suspect had a lot to do with wanting to connect with people like his father, and being too shy and awkward to know how. The frustration made him fight fiercely against that urge for a long time.

One day, miraculously, he lost. He had just read the book I am trying to pester out of the library now, Megrim by Edward Liveing, and had just taken a great many amphetamines, where by a 'great many' I mean a really unwisely large amount, which you could do in the 1960s, because they were legally sold OTC. Megrim, he realized, was more a history than a study; it was less about migraines than about the migraineurs, and how their disorder affected their lives. He found himself riding the euphoria of the drug and becoming upset that no one could see past the clinical side of medicine anymore, and wondering who remained who could write such a fascinating and touching investigation into their patients. And then realizing, suddenly, that it would have to be him.

I don't know if you're aware of the effect speed has on the average human, but it's not known for being an empathogen. It's much better at turning people into tweaky assholes. That Sacks could eat a quadruple handful of bennies and get a revelation like that one out of his borderline amphetamine-psychosis says a great deal about the kind of man he was. It kicked off a four-decade career of incredibly touching anthropological writing.

By far Dr Sacks' most famous work is Awakenings, the 1973 book about his work with the victims of encephalitis lethargica at Beth Abraham Hospital in New York. (It was later turned into a major motion picture. The movie does not contain Oliver Sacks, so I never have gotten around to seeing it.) Technically, it's a series of case studies, but the reality is far beyond that. The depth of the humanity in his writing is breathtaking. Every passage is a reminder that each of these cases is also a person, with a life and a history. He had found a clinical environment, I think, that gave him a formal framework for interacting with his patients in which he felt comfortable. Freed from having to guess at where he stood with everyone and what he was supposed to be doing, he found himself not only caring a great deal, but now also being able to usefully channel it.

Sacks was known to protest that his work was not that lyrical. I respectfully disagree. I don't recall him having any synaesthesiae, at least not while sober, but he worked by analogy and his descriptions tended to be multi-modal in a way that tickles the same circuits in my brain that think Russian sounds of leather-bound books and dark wood paneling closing in, and that cheap rooibos tastes of varnish and a smooth resin ball propped between my tongue and the roof of my mouth. He had a knack for using neurological jargon as precision poetry. As a clinician, the catalog of symptoms were void of any value judgement, but as a chronicler, the words converged with pinpoint accuracy on just what was happening to his patients, and suggested the effect it would have on their lives. It is some of the most technically meticulous, and deeply compassionate, writing that I have ever seen.

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