Friday, September 4, 2015

Oliver Sacks, MD: The Mind Explorer

A small tribute to the brilliantly unconventional neurologist and writer Dr. Oliver Sacks and his efforts to tell us the many ways our brain makes us human.

It was quite coincidental and a bit unnerving to read about death of the renowned British neurologist and best-selling author Dr. Oliver Sacks in The New York Times last Sunday right when I was reading his book An Anthropologist on Mars. Everyone has those moments when they get inspired by works of distinction and decide to utilize their resources for a similar cause of nobility. For any aspiring clinician or life science researcher, the amazingly prolific men of letters who are passionate biologists, provide a never-ending source of information and inspiration these days. This clan is kept active by Richard Gregory, Colin Blakemore, Steven Pinker, Carl Sagan, Stephen Gould, Dan Dennet, Richard Dawkins, Paul Davies and of course Oliver Sacks. There couldn’t be any life science enthusiast among us who hasn’t read at least a single literary work of these gifted souls.

Understanding human mind is complex science but depicting it in exquisite details to millions of people is sheer artistry. Through his prolific literature on ‘abnormal’ minds, Dr. Oliver Sacks described the intricacies of ‘normal’ mind. The New York Times described him as “The Poet Laureate of Medicine”. Except his latest book On The Move: A Life, which is autobiographical, all his books are his recollections and narrations about the intellectual and perceptual aberrations he has witnessed in his clinical career.

Oliver Sacks was first noticed by the contemporary scientific and literary society for his best-selling non-fiction book Awakenings in 1973. He meticulously described the impact and effects of the 1920s epidemic of Encephalitis lethargica when these patients reported to Beth Abraham Hospital in Bronx in 1960s. They had motor and behavioral abnormality of catatonia due to which they would not mentally or physically respond to any kind of stimulus. In simple terms, they were practically in continuous stupor even when awake. Dr. Sacks experimentally used L- Dihydroxyphenylalanine (L-DOPA) to increase dopamine levels in the neurological system of his patients, successfully alleviating their symptoms, hence an ‘Awakening’ to them after decades of sleep. L-DOPA was only prescribed for Parkinsonism then, which of course earned Arvid Carlsson and William S Knowles Nobel Prizes in 2000 and 2001 respectively. Yes, you guessed it right. The very disturbing, Academy Award-nominated film of 1990, Awakenings starring Robert De Niro and Robin Williams that left you with many sleepless nights with turbulent minds, was adapted from this book.

The complexities of an abnormal brain were courageously narrated in his most popular book The Man Who Mistook His Wife for a Hat and Other Clinical Tales. The title was adapted from the case history of one of his visually agnostic patients. The patient had abnormal visual perceptions initiated by his temporal and occipital lobes due to which all he could see in his own wife was a grey hat. There’s the haunting description of a man who used to pull himself from his bed to floor all through day and night as he thought his own paralyzed arm was a cadaver limb left in his bed by pranksters. Imagine a situation where we don’t have control over our own mind, the one singularity that determines our personality, identity, thoughts and actions. We become practically non-functional even with an absolutely healthy body. It is, in fact, most debilitating to live with and the most complicated disability to manage that mankind has ever endured.

For me, the most disturbing account was that of a surgeon with Tourette’s Syndrome described in his book An Anthropologist on Mars. He had compulsory tics all through his life except when he was operating on his patients. But ironically, the most inspiring clinical tales also come from the same book. An artist who loses color vision develops extraordinary aesthetic perceptions through different hues of black and white. The renowned activist Mary Temple Grandin, an autistic with severe social inhibitions builds a successful academic career by understanding the most complex inter-personal interactions through her intuitive understanding of animal behavior. His books Hallucinations, A Leg to Stand On and The Mind’s Eye still have voracious readers in all strata of society.

 Dr. Sacks was never demoralized even when he was diagnosed with uveal melanoma in 2006. Productively continuing in his clinical and literary careers, he published his autobiography On The Move: A Life in April 2015 in which he positively elaborated coping with his disease and its exhaustive treatments which left him stereo blind. He succumbed to death with widespread lung and brain metastasis on 30th of August 2015. But the legacy of his adventures into the whirlpools and torpedoes of human brain will continue to inspire neurologists and neuroscientists across the planet forever. 

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