There is a Ukrainian saying that “It is no crime to steal a man’s wife or his book.” I have never understood the meaning of this but I did come to understand that it is not wise to lend books you especially like. I bought Oliver Sacks’s Awakenings in 1973 immediately after publication, as I had so enjoyed his first book Migraine (a condition from which I suffer myself). Both books disappeared from my shelves many years ago – in my enthusiasm I must have lent them to persons unremembered. Awakenings showed Sacks at his best (and made him famous) – a detailed account of the extraordinary experiences of post-encephalitic patients, frozen in both space and time, and briefly rescued by the drug L-DOPA.
He went on to write many more books in a similar vein – such as The Man Who Mistook his Wife for a Hat and An Anthropologist on Mars – in which the predicaments (and sometimes insights) of people with neurological disorders such as autism and Tourette’s – were depicted in precise and compassionate prose. They were in marked contrast to the impersonal case histories with which most modern doctors describe their patients. More than any other medical writer, he introduced the public to the idea that people with neurological illnesses are no less human than “normal” people.
As a young doctor Sacks wanted to be a research scientist but proved a dismal failure at laboratory work and found that his true vocation was working with patients with neurological disorders and writing about their experiences. There could be at times an obsessional element to his love of obscure medical literature reflecting, perhaps, the slightly obsessional personality he revealed in his autobiography On the Move – addiction to amphetamines, weight lifting (he was a 1961 California record breaker) and long-distance motorcycling (up to 1,000 miles at weekends).
Sacks died in 2015. The River of Consciousness is his last book, published posthumously, and is a collection of essays delving into the history of ideas and not a book of detailed case histories. It is, in a way, a summary, a looking back on a life’s writing.
As the editors say in the introduction, Sacks was a polymath who could range over many fields of art and science. Names fly thick and fast, especially Darwin, William James and Freud – but also Cantor (“my favourite mathematician”), Wagner, Edelman, Pinter and Pope. This puts the reader at a slight disadvantage as they are unlikely to be as well-read as Sacks. Might the history of science be truly similar to Eldredge and Gould’s evolutionary theory of punctuated equilibrium? Is it right to compare music students at Juilliard with young scientists? Does chaos theory explain migraine? Reading these essays at times left me feeling pulled in different directions, uncertain as to whether I felt inspired or embarrassingly dumb or just dubious.
The book takes its title from the chapter of the same name. The psychologist Stuart Sutherland famously wrote (in the 1989 International Dictionary of Psychology) that consciousness “is a fascinating but elusive phenomenon… nothing worth reading has been written on it”. Sacks reprises some of the early writing that Sutherland dismissed so pithily – Hume, William James and Bergson – before discussing the flood of writing on the subject since Sutherland.
I must confess that I feel that there is still considerable truth in what Sutherland wrote. Consciousness is entirely subjective and cannot be observed or measured (other than by yourself, so any experiments in altering your own consciousness will disrupt your ability to observe or remember it). This limits what can be written about it, and theories of consciousness, and how it arises within nervous systems, must necessarily remain essentially speculative. It remains to be seen whether the two massively financed current projects into brain structure – the Connectome in the US and Blue Brain in Europe – will shed any new light on how brains generate consciousness.
Other chapters are about the fallibility of memory and the mystery of creativity, especially when viewed through the prism of the autistic savants Sacks made famous. Two chapters are about the way that the division between plant and animal life is not as clear-cut as is often thought. It is worth reading the book for one chapter alone – on Darwin and flowers. “It is hardly an exaggeration,” wrote Darwin in The Power of Movement in Plants, “to say that the tip of the radicle… acts like the brain of one of the lower animals.”
Sacks also discusses Darwin’s work with earthworms and his description of their “mental qualities”. Kandel’s ground-breaking work on memory formation by synapses, Sacks reminds us, was carried out on Aplysia, the giant sea snail. You do not necessarily have to believe in talking to plants, or that worms can think, to accept that nature is always more complex and full of surprises than we expect, and Sacks’s great gift is to convey this sense of wonder. “I rejoice in the knowledge of my biological antiquity,” he writes, “and [in] my biological kindred with all other forms of life. This knowledge roots me… allows me to feel at home in the natural world, to feel that I have my own sense of biological meaning.”
This book will remain safely on my bookshelf, strongly recommended but not lent.
Henry Marsh’s most recent book is “Admissions: a Life in Brain Surgery” (Weidenfeld & Nicolson)
The River of Consciousness
Picador, 256pp, £18.99
This article appears in the 22 Nov 2017 issue of the New Statesman, Europe: the new disorder