Unsolicited Advice

Well, hell. I finally managed to sit down and get past the Preface in Liveing's On Megrim , and ho- lee mackerel, I think I know exactly why this got Sacks' attention. The very first chapter is "Illustrative Cases" -- a few case studies, both Liveing's own patients and those of a few other neurological writers of his time. He covers, in brief, Du Bois Reymond's case of a man with classic hemicranial cephalgia accompanied by nausea, erythema of the face, and blood pressure changes; his own patient, a young woman with severe headache and general 'sea sickness', whose attacks are terminated by sleep; another of his patients, a man who suffered pure ocular migraine with various fun scintillating scotomata in his central vision; a man whose migraine attacks could be brought on by either a violent emotional or physical effort or gastric upset, and comes on with a burst of flickering scotomatous lights; and mentions of patients belonging to Parry and Wolla...

If I have seen further, it is by standing on the shoulders of giants. -- Isaac Newton (and anyone who has ever been assigned a term paper on a weird topic) The library has finally coughed up my 19th c. loan book about migraines. On Megrim, Sick-Headache, & some allied disorders , by Edward Liveing. It is a rather more substantial book than I expected, especially in library-style case binding, and I did not have much fun hauling it all over town for the afternoon. I have learnt that I have to make my library run on the way into work at 1pm rather than on the way out of it at 6, if I want to have any chance at all of getting back on the Green when I come out. I've only flipped through it, but I'm pretty sure I know where Sacks got his chronic case of hyperannotatia. Liveing doesn't get quite as ambitious with the length of his footnotes, but to make up for it, a good proportion of them are in untranslated French. The fact that this book exists at all is rather...

When Oliver Sacks first published Awakenings in 1973, he was largely ignored by his fellow neurologists. The reason often given to him was prosaic: Neurological case studies were not in the first person, did not involve the clinician's feelings, and were full of numbers and graphs. What he wrote wasn't clinical research, so it was beneath their notice. The reason slightly less often given to him was that nobody believed him. Most of the patients first given L-DOPA had a conventional form of Parkinson's disease. PD is caused by a decline in dopaminergic neurons in a small region of the brain called the substantia nigra, and the body is so good at compensating for this that you don't even see symptoms until the substantia nigra is about 80% gone. It is progressive, and the course varies; it takes a good goddamn long time for most Parkinson's patients to degenerate to the state in which Sacks' encephalitis lethargica victims were when he first tried L-DOPA, and m...

You learn interesting things when you go poking through biographies. Sacks never talked about his love life in his books, aside from a few stray comments that implied that at one point, he'd had one. I did wonder from time to time, but given the depth and breadth of the things he did share, it felt ungrateful to perseverate on the one he'd decided not to. So I didn't. I was interested to note that when he passed away a few months ago, he left a partner behind: Bill Hayes, another author who published essays at The New York Times . I found I was very glad to hear that. Sad for Hayes, but you know what I mean. Not that romance is the be-all and end-all of human existence, but Sacks had opted out of it for many, many years. I am glad that he lived through enough time and tide and social change that when he found he wanted that kind of connection, he also found he was free to take it. I gather it was not easy. There are a few years between Hayes writing tactfully of, ...

Still rummaging through the library for things involving Oliver Sacks. I've got a book by a long-dead neurologist who is not the same long-dead neurologist whose work I was trying to beat out of the Interlibrary Loan people, but which nevertheless coincidentally also has a foreword by Sacks. It's a very Sacks-ian foreword, aside from them not letting him take up half the page with footnotes. (The footnotes in Oliver Sacks' books make me feel that my incessant tangenting is completely reasonable. Minimalist, even. He's written entire parallel chapters at the bottom of his manuscript pages, and they're fascinating .) A R Luria is not as vivid and intertwined with his case as Sacks has always been, but I see where he got it from. I owe a great many things to Oliver Sacks. Not the least of these is the idea that having a brain full of blue and purple wire is not necessarily a bad thing. Sacks was the first writer I had ever run across -- and still one of the very fe...

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. ...