On the Move

On the Move Plot Summary

Introduction

In the sterile corridors of a Bronx hospital in the late 1960s, a young neurologist spent hours with patients others had long abandoned as hopeless cases. While his colleagues rushed through rounds, Oliver Sacks sat beside beds of those frozen in time by the aftermath of a decades-old epidemic, speaking to them softly, playing them music, and meticulously documenting their smallest responses. This extraordinary dedication to understanding the human experience behind neurological disorders would eventually transform not only the field of neurology but our cultural understanding of the brain itself. Oliver Sacks occupied a unique position at the intersection of science and humanities, combining rigorous medical observation with profound empathy and literary craftsmanship. Through his life and work, we witness the power of curiosity that transcends disciplinary boundaries, the courage to challenge medical orthodoxy, and the profound insight that emerges when scientific precision meets human compassion. His journey from a chemistry-obsessed London boy to a revolutionary medical storyteller reveals how the most meaningful scientific advances often come not from detached observation but from deep engagement with the full complexity of human experience.

Chapter 1: Scientific Roots: A Childhood of Curiosity

Oliver Sacks was born in London in 1933 to a family steeped in science and medicine. Both his parents were physicians—his mother one of England's first female surgeons and his father a compassionate general practitioner. The Sacks household buzzed with medical discussions, and young Oliver absorbed this atmosphere of scientific inquiry from his earliest days. His mother's anatomical diagrams and his father's case discussions provided a foundation for his later career, though his path would diverge significantly from their more conventional medical practices. Chemistry became Oliver's first intellectual passion. By age ten, he had transformed part of the family home into a makeshift laboratory where he conducted experiments with an intensity unusual for a child. His uncle, whom he later immortalized as "Uncle Tungsten," further nurtured this fascination by introducing him to the wonders of metals and elements. These early explorations instilled in Oliver not just scientific knowledge but a way of seeing the world—attentive, methodical, and alive to the hidden patterns beneath ordinary appearances. World War II disrupted this scientific idyll when, at age six, Oliver and his brother were evacuated from London to escape German bombing. Sent to a boarding school in the countryside, he endured years of neglect and cruelty at the hands of a sadistic headmaster. This traumatic separation from his family left emotional scars that would influence his development and perhaps contributed to the deep empathy he later showed for vulnerable patients. Upon returning to London after the war, he retreated further into his scientific pursuits, finding in chemistry a predictable order that contrasted with the human chaos he had experienced. As adolescence approached, Oliver's interests expanded to include biology and the natural world. He spent hours observing and cataloging plants and animals, developing the keen observational skills that would later distinguish his neurological work. His childhood bedroom gradually transformed from a chemistry laboratory to a naturalist's collection room filled with specimens and detailed journals. This shift from chemistry to biology foreshadowed his eventual movement toward medicine—a field that would allow him to combine scientific rigor with his growing interest in the complexities of living organisms. By the time he entered Oxford University to study medicine in 1951, Oliver had developed the essential qualities that would define his later work: meticulous observation, boundless curiosity, and a capacity to find wonder in the seemingly ordinary. Though he could not have known it then, these childhood passions were preparing him for a career that would revolutionize how we understand the relationship between brain and mind, science and humanity. His early experiences had taught him to look beneath surfaces, to document carefully, and to approach the unknown with both scientific precision and childlike wonder—lessons that would serve him well in exploring the most complex organ in the human body.

Chapter 2: Medical Training and Early Struggles

At Oxford, Oliver Sacks found himself in an environment that both challenged and frustrated him. Though brilliant in many ways, he struggled with the rigid structure of medical education. His mind worked associatively rather than linearly, making connections across disciplines while sometimes neglecting the focused memorization expected in his courses. He excelled at essay writing and theoretical discussions but performed poorly on standardized examinations, failing his "prelims" multiple times before finally passing. This pattern revealed a mind more suited to exploration than standardization—a trait that would later make him an innovative clinician but created obstacles during his training. The clinical years brought Sacks face-to-face with human suffering, triggering both empathy and anxiety. While many of his peers maintained professional detachment, he found himself deeply affected by his patients' stories and struggles. This emotional engagement initially seemed a liability in medical settings where objectivity was prized above compassion. Yet this very sensitivity would eventually become his greatest strength, allowing him to perceive dimensions of illness that more detached observers might miss. His clinical supervisors noted his unusual attentiveness to patients but worried about his difficulty in maintaining boundaries. After completing his medical degree in 1958, Sacks began a series of internships and residencies that gradually led him toward neurology. The human brain, with its unfathomable complexity and its role as the seat of consciousness, captured his imagination like nothing else. He was particularly drawn to cases where neurological disorders altered patients' perceptions or sense of self, raising profound questions about the nature of identity and reality. While his colleagues often focused narrowly on diagnosis and treatment, Sacks found himself equally interested in how patients experienced and made meaning of their conditions. In 1960, feeling constrained by the hierarchical British medical system and seeking adventure, Sacks made the momentous decision to move to North America. After a brief stay in Canada, he traveled to the United States, where he would remain for the rest of his life. This geographical transition mirrored an internal one—a movement away from conventional medical practice toward a more individualized approach. In California, where he completed his neurology residency, Sacks embraced not only his professional training but also the physical culture of the region, becoming an avid motorcyclist and weightlifter who once set a California state record by squatting 600 pounds. These years of training and transition were marked by personal struggles as well as professional development. Sacks battled drug addiction, particularly to amphetamines, which he later described as a desperate attempt to manage his social anxiety and depression. He also grappled with his homosexuality at a time when it remained stigmatized and, in many places, criminalized. These personal challenges contributed to a sense of alienation but also deepened his understanding of human vulnerability and the complex relationship between brain chemistry and behavior—insights that would later inform his compassionate approach to patients with neurological differences. By the mid-1960s, Sacks had completed his formal training but was still searching for his professional identity. Though brilliant in many ways, he struggled to fit into conventional medical practice. His tendency to spend hours with individual patients, his interest in their subjective experiences, and his reluctance to reduce complex cases to simple diagnoses marked him as an outlier. It would take an extraordinary encounter with a group of forgotten patients to help him discover his unique contribution to medicine and begin his transformation from conventional neurologist to pioneering medical storyteller.

Chapter 3: Awakening: Finding His Voice in Neurology

In 1966, Oliver Sacks began working at Beth Abraham Hospital in the Bronx, where he encountered a group of patients who would transform his understanding of neurology and launch his literary career. These were survivors of the 1920s epidemic of encephalitis lethargica, or "sleeping sickness," who had been institutionalized for decades in a frozen, parkinsonian state. Most of the medical establishment had written them off as hopeless cases, but Sacks approached them with extraordinary patience and curiosity. He spent hours observing their unusual movements and behaviors, keeping detailed journals that went far beyond standard medical documentation. The introduction of the drug L-dopa in 1969 provided an opportunity to treat these long-forgotten patients. The results were dramatic and complex. Many patients who had been immobile for decades suddenly "awakened," regaining movement, speech, and full awareness of their surroundings. However, these awakenings were often followed by troubling side effects and complications as patients developed extreme sensitivity to the medication. Rather than seeing these responses as mere pharmacological reactions, Sacks recognized them as windows into the brain's most fundamental workings and the nature of human consciousness itself. When Sacks attempted to publish his observations in medical journals, he encountered resistance. His detailed case reports focusing on individual patients ran counter to the statistical approach favored in medical research. Editors criticized his literary style and questioned the scientific validity of his narrative approach. This rejection by the medical establishment pushed Sacks toward a different form of expression. Inspired by the neuropsychologist A.R. Luria's case history "The Mind of a Mnemonist," he began writing detailed narratives about his patients that combined clinical observation with humanistic understanding. The result was "Awakenings," published in 1973, a book that defied easy categorization. Neither a conventional medical text nor a work of fiction, it presented detailed case histories of Sacks's postencephalitic patients, capturing not just their neurological symptoms but their struggles to reclaim their identities after decades of isolation. The book received enthusiastic reviews from literary critics but was largely ignored by the medical community. This pattern of recognition from outside medicine while being marginalized within it would continue throughout Sacks's career. This period marked Sacks's emergence as a unique voice in neurology—one that insisted on seeing patients not as collections of symptoms but as human beings striving to maintain coherence and meaning in the face of neurological challenge. He developed a distinctive approach that combined rigorous scientific observation with deep empathy and narrative understanding. Where conventional neurology focused primarily on deficits and pathology, Sacks became increasingly interested in how patients adapted to their conditions, often developing remarkable compensatory strategies or finding unexpected meaning in their altered states. By the mid-1970s, Sacks had found his calling as what he called a "neuro-anthropologist"—someone who studied not just the physical brain but the lived experience of neurological difference. Though still practicing clinical neurology, he increasingly devoted himself to writing case histories that illuminated the human dimensions of brain disorders. This unique position between medicine and literature allowed him to bridge worlds that had long been separated, bringing scientific insights to general readers while reminding medical professionals of the human stories behind their diagnoses. In finding his voice, Sacks had begun to transform not just his own career but the field of neurology itself.

Chapter 4: The Art of Clinical Storytelling

What distinguished Oliver Sacks's case studies from conventional medical reports was his recognition that illness narratives could be a form of literature—not merely records of symptoms and treatments but explorations of human experience under extraordinary neurological circumstances. Drawing inspiration from the 19th-century tradition of detailed case histories, Sacks revitalized this approach for the modern era, combining scientific precision with literary craft to create accounts that were both medically informative and humanly compelling. Each of Sacks's case studies began with careful clinical observation. He would spend hours with patients, noting not just their obvious symptoms but subtle details of posture, speech patterns, and emotional responses. He often used unconventional assessment methods, taking patients on walks, sharing meals with them, or observing them in their home environments rather than relying solely on office examinations. This immersive approach yielded insights that might have been missed in more formal clinical settings and allowed him to understand how neurological conditions manifested in real-world contexts. Beyond observation, Sacks emphasized the importance of listening to patients' own accounts of their experiences. He recognized that even those with severe cognitive or perceptual disorders possessed a unique perspective on their condition that no external observer could fully access. By treating these subjective reports as valuable data rather than mere anecdotes, he gained insights into the phenomenology of neurological conditions—how it felt, for example, to lose one's sense of proprioception or to experience musical hallucinations. This approach required patience, imagination, and a willingness to enter into unfamiliar perceptual worlds. In crafting his narratives, Sacks drew on a lifetime of reading across disciplines. His case studies are filled with references to literature, philosophy, and history that illuminate the human dimensions of neurological conditions. When describing a man with visual agnosia who could no longer recognize faces, Sacks might invoke Descartes' reflections on perception; when exploring a musician's amnesia, he might reference Proust's meditations on memory. These connections placed individual cases within broader intellectual contexts, revealing their significance beyond the clinical realm. Critics sometimes accused Sacks of exploiting his patients or presenting them as curiosities for public consumption. He wrestled with these ethical concerns throughout his career, developing practices to protect privacy while still sharing stories he believed had broader significance. Most patients, when consulted, enthusiastically supported his writing, often expressing gratitude that their experiences were being treated with such seriousness and dignity. Many felt that Sacks had given voice to aspects of their condition that they had struggled to communicate to others. The publication of "The Man Who Mistook His Wife for a Hat" in 1985 brought Sacks widespread recognition beyond medical circles. This collection of case histories explored a range of neurological conditions—from visual agnosia to Tourette's syndrome to autism—always with an emphasis on how patients experienced these conditions from the inside. The book's unexpected commercial success demonstrated a public hunger for medical writing that addressed the human dimensions of illness and the mysteries of the brain. Through this work and subsequent collections, Sacks established clinical storytelling as a valuable approach to understanding neurological conditions—one that complemented rather than replaced more conventional scientific methods.

Chapter 5: Bridging Science and Humanity

At the heart of Oliver Sacks's approach to neurology was a conviction that scientific understanding and human empathy were not opposing values but complementary aspects of a complete medical practice. While many of his contemporaries embraced increasingly technological and reductionist approaches to brain disorders, Sacks insisted that neurology must address not just the physical brain but the person who inhabited it—a being with memories, desires, fears, and an ongoing struggle to maintain identity in the face of neurological challenge. This integrative vision was evident in Sacks's clinical method. He combined rigorous scientific observation with a deep interest in patients' subjective experiences, recognizing that both perspectives were necessary for a full understanding of neurological conditions. When examining a patient with Parkinson's disease, for instance, he would note not just the physical symptoms—tremor, rigidity, bradykinesia—but how these manifestations affected the person's sense of self and relationship to the world. This dual focus allowed him to perceive dimensions of illness that more narrowly scientific approaches might miss. Sacks's empathic stance was not merely a matter of bedside manner but a methodological principle. He believed that understanding how patients experienced their conditions from the inside was essential to effective diagnosis and treatment. This approach required patience, imagination, and a willingness to enter into unfamiliar perceptual worlds—to try to grasp, for example, how a person with visual agnosia made sense of a world where familiar objects had become unrecognizable, or how someone with Tourette's syndrome experienced the urges and tics that others saw only from the outside. This commitment to understanding patients' lived experiences led Sacks to question prevailing medical models that emphasized deficits and pathology. Increasingly, he came to see neurological differences not simply as disorders to be corrected but as alternative ways of being that might include unique capabilities alongside limitations. His writings on autism, for instance, highlighted not just the social and communicative challenges associated with the condition but the remarkable perceptual abilities, memory skills, or artistic talents that some autistic individuals possessed. This perspective anticipated later movements toward neurodiversity and more strength-based approaches to neurological differences. Sacks's approach was profoundly influenced by his own experiences of altered consciousness. His experiments with drugs in the 1960s, his migraines with their visual distortions, and later his own medical challenges—including the loss of stereoscopic vision due to ocular cancer—gave him firsthand knowledge of how neurological changes could transform perception and identity. These personal experiences fostered both humility about the limits of objective understanding and conviction that subjective reports of unusual mental states should be taken seriously. As his career progressed, Sacks increasingly emphasized the brain's adaptability and the human capacity for resilience in the face of neurological challenge. Where earlier medical models had often presented brain damage as irreversible and adaptation as limited, his case studies revealed remarkable examples of compensation and recovery—the blind person who developed heightened hearing, the amnesiac who found new ways to organize daily life, the aphasic who communicated through music when words failed. These accounts offered hope without false promises, acknowledging real limitations while recognizing the brain's remarkable plasticity and the human spirit's resourcefulness.

Chapter 6: Personal Journeys and Self-Discovery

Despite his growing fame as an author and neurologist, Oliver Sacks remained in many ways a deeply private person, struggling with insecurities and personal challenges that he largely kept hidden from public view. Throughout much of his career, he maintained a careful separation between his professional persona and his private life, revealing little about his own experiences in his published works. This reticence reflected both his natural shyness and his concern that personal disclosure might undermine his scientific credibility in an era when objectivity was prized above all. Sacks's personal life was shaped by early experiences of rejection and isolation. When he revealed his homosexuality to his mother as a young man, she responded with harsh condemnation, telling him, "I wish you had never been born." This painful rejection from someone he loved deeply created wounds that would take decades to heal and influenced his complex relationship with intimacy throughout his life. For many years, he lived a largely solitary existence, finding connection primarily through his work with patients and his writing rather than through close personal relationships. Physical activities provided Sacks with important outlets for expression and self-discovery. Swimming remained a lifelong passion, offering a sense of weightlessness and freedom that counterbalanced his social awkwardness on land. He continued his weightlifting well into middle age, finding in physical exertion a form of meditation and bodily awareness that complemented his cerebral pursuits. Motorcycle riding, though eventually abandoned after serious accidents, had given him experiences of speed and freedom that he treasured. These physical pursuits revealed a man whose intellectual life was deeply grounded in bodily experience—a connection that informed his understanding of his patients' embodied consciousness. Throughout his life, Sacks maintained a complex relationship with his Jewish heritage. Though not religiously observant, he was deeply influenced by the intellectual traditions of Judaism, particularly its emphasis on textual interpretation and ethical questioning. His parents' scientific rationalism had largely displaced religious practice in their home, yet Sacks retained a spiritual sensibility that found expression in his wonder at the natural world and his reverence for human consciousness. This spiritual dimension became more explicit in his later writings, which often touched on questions of meaning and transcendence in the context of neurological experience. In his sixties and seventies, Sacks gradually became more open about his personal life. His memoir "Uncle Tungsten" revealed aspects of his childhood and family history, while "On the Move," published shortly before his death, offered a more comprehensive autobiography, including frank discussions of his sexuality, his drug use in the 1960s, and his decades of celibacy. This increasing openness coincided with significant personal happiness when, at age 77, he fell in love with the writer Billy Hayes, forming his first lasting romantic relationship. Friends noted a new lightness in his demeanor during these final years, as if he had finally integrated the personal and professional aspects of his identity. Sacks's approach to his own mortality revealed the same curiosity and attentiveness he had brought to his patients. When diagnosed with terminal cancer in 2015, he wrote about the experience with remarkable equanimity. Rather than focusing on what he was losing, he expressed gratitude for the life he had lived and the connections he had formed. "I cannot pretend I am without fear," he wrote in The New York Times. "But my predominant feeling is one of gratitude." This final public statement echoed the themes that had run throughout his work: the search for meaning in the face of biological limitations and the capacity of consciousness to transcend even the most challenging circumstances.

Chapter 7: Legacy: Transforming Medical Narratives

Oliver Sacks died on August 30, 2015, leaving behind a body of work that transformed not just neurology but our cultural understanding of the brain and its disorders. His greatest legacy lies in his demonstration that medicine at its best is both a science and a humanity—a practice that requires rigorous observation and analysis but also empathy, narrative understanding, and respect for the uniqueness of each individual. Through his writing, he invited readers into the mysterious terrain of the human brain, revealing it as not merely an organ to be studied but the biological basis of our identity, creativity, and connection to others. Sacks's influence extended far beyond neurology into multiple disciplines and cultural domains. His work helped inspire the development of narrative medicine, a field that trains physicians to attend to patients' stories as well as their symptoms. His case histories provided models for how medical writing could be both scientifically accurate and humanly engaging, influencing generations of physicians and science writers. In psychology and cognitive science, his detailed observations of unusual mental states contributed to evolving theories of consciousness and perception. His emphasis on the adaptive capacities of the brain anticipated later research on neuroplasticity and resilience. Perhaps most significantly, Sacks helped transform public understanding of neurological differences. Where earlier popular accounts had often presented conditions like autism, Tourette's syndrome, or amnesia as simply tragic deficits, Sacks revealed the complex reality of lives that included both challenges and unique capabilities. His writings helped destigmatize neurological conditions by showing the full humanity of those who lived with them. Many individuals with these conditions have expressed gratitude for his portrayal of their experiences with dignity and nuance, giving voice to aspects of their lives that had previously been misunderstood or ignored. The impact of Sacks's work extended into the arts as well. Filmmakers, playwrights, and composers found inspiration in his case histories, adapting them into works that reached audiences who might never read a medical text. The film adaptation of "Awakenings," starring Robin Williams as a character based on Sacks, brought his approach to a global audience. These artistic interpretations further amplified his message about the complexity and resilience of the human mind, creating a cultural conversation about neurological difference that transcended medical contexts. In academic medicine, Sacks's legacy remains somewhat contested. Some critics continue to question the scientific rigor of his narrative approach or raise ethical concerns about his detailed portrayal of patients. Yet his influence is undeniable, particularly in the growing recognition that patient experiences matter not just for humane care but for scientific understanding. Increasingly, medical education incorporates elements of narrative competence alongside technical training, acknowledging that good doctors must be able to elicit, interpret, and respond to their patients' stories. For those who knew him personally, Sacks is remembered not just for his professional achievements but for his childlike enthusiasm, his encyclopedic knowledge across disciplines, and his genuine interest in others. Despite his fame, he maintained a modest lifestyle and continued seeing patients well into his seventies. His personal qualities—curiosity, empathy, and the courage to challenge conventional boundaries—were inseparable from his professional contributions. In bridging the worlds of science and humanities, objective observation and subjective experience, Sacks created a legacy that continues to inspire those who seek a more integrated understanding of the human condition.

Summary

Oliver Sacks's extraordinary journey from a chemistry-obsessed London boy to a globally renowned neurologist-author exemplifies the power of bridging seemingly disparate worlds. Through his unique combination of scientific rigor and profound human empathy, he transformed our understanding of neurological conditions and the people who live with them. His greatest contribution was his insistence that medicine must address not just the biological mechanisms of disease but the lived experience of patients—their struggles to maintain identity, find meaning, and adapt to altered neurological states. By approaching his patients with both clinical precision and narrative sensitivity, he revealed the brain not merely as an organ to be studied but as the biological foundation of our humanity. The enduring lesson of Sacks's life and work is that true understanding requires both objective observation and subjective connection. In an age increasingly dominated by technological approaches to medicine, his example reminds us that healing involves recognizing the full humanity of those we seek to help. For scientists, his work demonstrates how narrative and empathy can enrich research; for humanists, it reveals how scientific knowledge can deepen our appreciation of human experience; and for all of us, it offers a model of curiosity, compassion, and courage in the face of life's inevitable challenges. Those who wish to follow in his footsteps—whether as medical professionals, writers, or simply thoughtful human beings—would do well to adopt his practice of careful observation combined with genuine connection, his willingness to cross disciplinary boundaries, and his lifelong commitment to learning from those whose experiences differ from our own.

About Author

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Oliver Sacks

Oliver Wolf Sacks, CBE, was a British neurologist residing in the United States, who has written popular books about his patients, the most famous of which is Awakenings, which was adapted into a film of the same name starring Robin Williams and Robert De Niro.Sacks was the youngest of four children born to a prosperous North London Jewish couple: Sam, a physician, and Elsie, a surgeon. When he was six years old, he and his brother were evacuated from London to escape The Blitz, retreating to a boarding school in the Midlands, where he remained until 1943. During his youth, he was a keen amateur chemist, as recalled in his memoir Uncle Tungsten. He also learned to share his parents' enthusiasm for medicine and entered The Queen's College, Oxford University in 1951, from which he received a Bachelor of Arts (BA) in physiology and biology in 1954. At the same institution, he went on to earn in 1958, a Master of Arts (MA) and an MB ChB in chemistry, thereby qualifying to practice medicine.After converting his British qualifications to American recognition (i.e., an MD as opposed to MB ChB), Sacks moved to New York, where he has lived since 1965, and taken twice weekly therapy sessions since 1966.Sacks began consulting at chronic care facility Beth Abraham Hospital (now Beth Abraham Health Service) in 1966. At Beth Abraham, Sacks worked with a group of survivors of the 1920s sleeping sickness, encephalitis lethargica, who had been unable to move on their own for decades. These patients and his treatment of them were the basis of Sacks' book Awakenings.His work at Beth Abraham helped provide the foundation on which the Institute for Music and Neurologic Function (IMNF), where Sacks is currently an honorary medical advisor, is built. In 2000, IMNF honored Sacks, its founder, with its first Music Has Power Award. The IMNF again bestowed a Music Has Power Award on Sacks in 2006 to commemorate "his 40 years at Beth Abraham and honor his outstanding contributions in support of music therapy and the effect of music on the human brain and mind".Sacks was formerly employed as a clinical professor of neurology at the Albert Einstein College of Medicine and at the New York University School of Medicine, serving the latter school for 42 years. On 1 July 2007, Columbia University College of Physicians and Surgeons appointed Sacks to a position as professor of clinical neurology and clinical psychiatry, at the same time opening to him a new position as "artist", which the university hoped will help interconnect disciplines such as medicine, law, and economics. Sacks was a consultant neurologist to the Little Sisters of the Poor, and maintained a practice in New York City.Since 1996, Sacks was a member of The American Academy of Arts and Letters (Literature). In 1999, Sacks became a Fellow of the New York Academy of Sciences. Also in 1999, he became an Honorary Fellow at The Queen's College, Oxford. In 2002, he became Fellow of the American Academy of Arts and Sciences (Class IV—Humanities and Arts, Section 4—Literature).[38] and he was awarded the 2001 Lewis Thomas Prize by Rockefeller University. Sacks was awarded honorary doctorates from the College of Staten Island (1991), Tufts University (1991), New York Medical College (1991), Georgetown University (1992), Medical College of Pennsylvania (1992), Bard College (1992), Queen's University (Ontario) (2001), Gallaudet University (2005), University of Oxford (2005), Pontificia Universidad Católica del Perú (2006). He was appointed Commander of the Order of the British Empire (CBE) in the 2008 Birthday Honours. Asteroid 84928 Oliversacks, discovered in 2003 and 2 miles (3.2 km) in diameter, has been named in his honor.

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