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Insomniac City: Bill Hayes’s Extraordinary Love Letter to New York, Oliver Sacks, and Love Itself

“The most we can do is to write — intelligently, creatively, evocatively — about what it is like living in the world at this time.”

Insomniac City: Bill Hayes’s Extraordinary Love Letter to New York, Oliver Sacks, and Love Itself

“If you are too much like myself, what shall I learn of you, or you of me?” Mary Oliver wrote in her beautiful meditation on how differences bring couples closer together. This life-expanding recompense of embracing otherness graces every meaningful relationship, be it the love of a person or the love of a place, and it comes alive with uncommon splendor in Insomniac City: New York, Oliver, and Me (public library) — the poetic and profound more-than-memoir by the writer and photographer Bill Hayes.

After the sudden death of his partner of sixteen years, Hayes — a lifelong insomniac — leaves San Francisco for New York in search of a fresh start. He finds himself in a city where “life is a John Cage score, dissonance made eloquent,” where “every car on every train holds a surprise, a random sampling of humanity brought together in a confined space for a minute or two — a living Rubik’s Cube.” Slowly, his heart begins to awaken from the coma of grief and he falls in love again — first with the city, then with an improbable new paramour: the late, great neurologist and writer Oliver Sacks. He learns that New York, like love, is demanding and difficult but rewards those who surrender to it unguardedly. Both can break your heart, and both can break it open if you embrace their irregular edges.

What emerges from this dual love letter is a lyrical reminder that happiness and heartache are inseparably entwined, and that without the tragic, the beautiful would be just a frayed strand of half-being.

“Trees in the Park” by Bill Hayes

Hayes writes:

I moved to New York eight years ago and felt at once at home. In the haggard buildings and bloodshot skies, in trains that never stopped running like my racing mind at night, I recognized my insomniac self. If New York were a patient, it would be diagnosed with agrypnia excitata, a rare genetic condition characterized by insomnia, nervous energy, constant twitching, and dream enactment — an apt description of a city that never sleeps, a place where one comes to reinvent himself.

Alongside the portrait of New York Hayes paints a portrait of the irreplaceable Oliver Sacks — a largehearted genius of ceaseless eccentricity, who collects spectacles and dreams of fern salad and writes with a fountain pen and has never emailed or texted or owned a computer; who, when taught to open a champagne bottle in his late seventies, dons his swimming goggles “just in case”; who earnestly calls pot “cannabis” and exclaims with gusto when stoned into hallucination: “The primary cortex! The genius of the primary cortex!”; a man of imagination so infinite and empathy so complete that when asked what he has been doing lying in the garden for hours, he replies that he has been wondering about what it’s like to be a rose.

“Tea Time” by Bill Hayes

Hayes is the “Billy” in Dr. Sacks’s own magnificent memoir — the love of his life, whom he met after three and a half decades of singledom and celibacy. Dr. Sacks himself recounted their defining moment of mutuality: “[Billy] came to see me and (in the serious, careful way he has) said, ‘I have conceived a deep love for you.’ I realized, when he said this, what I had not realized, or had concealed from myself before — that I had conceived a deep love for him too — and my eyes filled with tears. He kissed me, and then he was gone.”

The two met when Dr. Sacks sent Billy a letter — one might say fan mail, though Hayes seems far too humble to call it that himself — after reading his book The Anatomist. Hayes writes:

He was without a doubt the most unusual person I had ever known, and before long I found myself not just falling in love with O; it was something more, something I had never experienced before. I adored him.

Indeed, Hayes’s is not so much a love letter, for even the most exquisite of the genre can slip into the formulaic, but a most unusual letter of adoration — of Oliver, and of New York.

“Oliver’s Desk” by Bill Hayes

Besides that deep love and mutual adoration, Hayes’s tender account of his life with Dr. Sacks — or “O,” as he appears in the book — reveals that they share a fervent yet ungrasping appreciation of what he so poetically calls “those rare moments when the world seems to shed all shyness and displays every possible permutation of beauty.” They share, too, a good-natured curiosity about the world — one about the natural world, the other about the human world. Both are fearless explorers, but Billy is the modern urban counterpart to O’s Darwin and Humboldt and Shackleton — while Dr. Sacks ventures to remote islands of exotic ferns and curious neuropathologies, Hayes ventures into a questionable artist warehouse, comforts the sad stranger on the train and the go-go boy with the existential crisis, chats up the elderly woodworker carving a letter opener at the corner of Eighth and Jane, has his eye drawn by a 95-year-old artist with bright orange hair, and follows into a dark alley the homeless poet who writes him a koan-sonnet onto a celestial map torn from an old New York Times.

Bill Hayes’s eye by Ilona Royce Smithkin

Hayes relays his disposition toward the city and its inhabitants:

I make a point of waving or nodding hello when I can. I have come to believe that kindness is repaid in unexpected ways and that if you are lonely or bone-tired or blue, you need only come down from your perch and step outside. New York — which is to say, New Yorkers — will take care of you.

Indeed, what often escapes the gliding visitor is the subterranean kindness that governs the city, that makes it not only bearable but beautiful. Hayes writes:

I’ve lived in New York long enough to understand why some people hate it here: the crowds, the noise, the traffic, the expense, the rents; the messed-up sidewalks and pothole-pocked streets; the weather that brings hurricanes named after girls that break your heart and take away everything.

It requires a certain kind of unconditional love to love living here. But New York repays you in time in memorable encounters, at the very least. Just remember: Ask first, don’t grab, be fair, say please and thank you, always say thank you — even if you don’t get something back right away. You will.

“Washington Square Park” by Bill Hayes

As he inhabits the city, Hayes is aglow with generous curiosity — not the greedy kind that makes souvenirs out of otherness but the warm, openhearted kind that seeks to understand and connect. He is a noticer of things — the white clouds backlit by the moon against the night sky, the hands of lovestruck couples “laced together as if in prayer,” the quality of the early morning air outside the busy subway station, “soft, as if unfinished dreams still emanated from everyone’s skin.” But perhaps, exactly contrary to the stereotype of the hasty New Yorker in a perpetual trance of busyness, every true New Yorker is — must necessarily be — a noticer of things, for this is a city where “beauty comes in unbeautiful ways.”

“Sam at His Newsstand” by Bill Hayes

Strewn throughout the narrative are notes — sometimes poetic, sometimes playful, always in close contact with the profound — from Hayes’s journal, which he began on Oliver’s suggestion one spring morning shortly after they fell in love. Many of these diary meditations are loving records of unusual, endearing proclamations Oliver makes as a matter of course — precious fossils of the peculiarities that made Oliver Sacks Oliver Sacks.

In an entry from January of 2010, Hayes records:

O: “Every day, a word surprises me.”

In another:

O: “Are you conscious of your thoughts before language embodies them?”

They are also capsules of the tenderness that flowed between them — tenderness colored by Dr. Sacks’s lovable idiosyncrasies:

O: “I like having a confusion of agency, your hand on top of mine, unsure where my body ends and yours begins.”


“I just want to enjoy your nextness and nearness,” O says.

In an entry from the winter of 2010, Hayes records:

Palace Hotel, San Francisco — Over Christmas:

In bed, lights out:

O: “Oh, oh, oh…!”

I: “What was that for?”

O: “I found your fifth rib.”

In the middle of the night: “Wouldn’t it be nice if we could dream together?” O whispers.

In another entry:

O, in the car, on a drive back from the Botanical Garden — reclining all the way back in his seat (because of sciatica); two pairs of sunglasses on (because of his eye) — suddenly speaks, startling me (I thought he’d been sleeping):

“I’ve suddenly realized what you mean to me: you create the need which you fill, the hunger you sate. Like Jesus. And Kierkegaard. And smoked trout…”

I: “That’s the most romantic thing anyone has ever said to me — I think.”

O chuckles, then adds: “It’s a kind of teaching, in a strange way…”

Later: I thought he was gazing at me lovingly as I drove, but then realized, no:

“I’m watching the odometer and thinking of the elements,” says O.

“O’s Periodic Table” by Bill Hayes

But love is, indeed, “a kind of teaching,” the tender mutuality of which Hayes captures in another entry under the heading “Random images and thoughts”:

How, during a daylong series of panels and performances on O’s work, he would repeatedly open his little tin and offer me a mint before taking one himself.

How, when we first met, he didn’t really know how to (or didn’t think so) share with another person. He’d never shared his life before, after all.

How when I didn’t feel well recently and took a long bath, he brought in to me a piece of toast with a slice of cheese on it. When I transferred to the bed, be brought me another slice.

On a particularly scenic July evening on the rooftop, the spectacle of the sunset aided by a touch of hallucinogens, Hayes contemplates the transcendent cross-pollination of differences that is love:

Taking in the great beauty of my surroundings — “an attack of beauty,” as O once said about a sunset — I thought two things: one, how there is so much in that head of his, so much O knows; and two, how different we are, in that what is going through my brain is not so much a stream of thoughts and images but of feelings and emotions. I am tuned into the people around me — the dynamics among the group of boys behind us, and the argument being had by the older couple right next to us, and my own complicated feelings. I may not know nearly as much as O knows, I am not as brilliant, but I feel a lot, so much, and some of this has rubbed off onto him and some of his knowledge has rubbed off onto me.

Undergirding their particular love story is the universal story of every love — that subtle yet indelible way in which two separate people come to permeate one another in the very fiber of their being, a mutual permeation works even across space and time: Those we love come to color even our past that predates them. Looking back on one of his first evenings in New York, Hayes recounts: “The tequila tasted as clean and bright as metal — like an element with a name I can’t pronounce.” He hadn’t yet fallen in love with Dr. Sacks, whose famous obsession with the periodic table would become part of their relationship — Oliver would later count Billy’s pushups by the names of the corresponding elements: “titanium, vanadium, chromium…” And yet Hayes’s mind had somehow revised his own memory with Dr. Sacks’s subsequent influence, for loving someone alters even our memory of who we were before we loved them.

“Studying Bach” by Bill Hayes

What becomes clear from Hayes’s journals is not only the soul-deep affection between them, but also those small, everyday acts of care of which that affection is woven:

“I hope I get a good night’s sleep and then have a rush of thoughts, as I did this morning,” says O. “It’s very delightful when that happens — all of them rushing to the surface, as if they have been waiting for me to become conscious of them…”

I help him get ready for bed — “de-sock” him, fill his water bottle, bring him his sleeping tablets, make sure he has something to read.

I: “What else can I do for you?”

O: “Exist.”

Indeed, these fragmentary glimpses reveal above all a man unwilling, perhaps even unable, to fragment himself; a man who embodies Van Gogh’s ethos that his “life and love are one” — for alongside these spontaneous pronouncements of love are equally spontaneous revelations of Dr. Sacks’s lifelong sense that “the act of writing is an integral part of [his] mental life.” In another journal entry, Hayes writes:

O: “I want a flow of good thoughts and words as long as I’m alive.”

In an entry written less than a year before Dr. Sacks’s death, Hayes records:

“Do you sometimes catch yourself thinking?” says O, out of the blue, in the car, on the way to his place in the country. “I sometimes sort of feel like I’m … looking at the neural basis of consciousness.”


“Those are special occasions,” he went on, “when the mind takes off — and you can watch it. It’s largely autonomous, but autonomous on your behalf — in regard to problems, questions, and so on.” A pause, then returning to his thought: “There are creative flights… Flights: that is a nice word.”

“Mmm, I love that word… What… triggers such flights for you?”

“Surprise, astonishment, wonder…”

“Back Home” by Bill Hayes

When knee surgery compounds the unbearable chronic pain of sciatica, making it impossible for Dr. Sacks to sit, he tells Hayes, who has built him a standing desk:

Writing is more important than pain.


O: “I thought being old would be either awful or trivial, and it’s neither.”

I: “What makes it not awful and not trivial?”

O: “Aside from you, thinking and writing.”

Hayes captures Dr. Sacks’s indivisible wholeness, this arduous resistance to the fragmentation of identity politics, in an exchange from the autumn of 2012:

Over dinner, O talking about his late friend Gaj — Carleton Gajdusek, a Nobel laureate in medicine — with great excitement and conviction, comparing him to Goethe, of whom it was said, O tells me, “He had a nature. A nature.”

I thought I knew what O meant — O, who has always disliked being pigeonholed, typed, as simply one thing or another, doctor or writer, gay or not, Jewish or atheist, etc. — but I wasn’t completely sure and prodded him.

“A nature,” he repeated, as if that was the only way to say it. “He wasn’t this or that, fitted with so many labels, an ‘identity,’ like people today, but all aspects of him were of a piece — this is who he was, not what he was; a force of nature, I suppose.”

“Under the Overpass” by Bill Hayes

Hayes — whose life has been marked by loss: his longtime partner Steve, his agent, mentor and dear friend Wendy Weil, and finally Oliver himself — considers the measure of aliveness:

I suppose it’s a cliché to say you’re glad to be alive, that life is short, but to say you’re glad to be not dead requires a specific intimacy with loss that comes only with age or deep experience. One has to know not simply what dying is like, but to know death itself, in all its absoluteness.

After all, there are many ways to die — peacefully, violently, suddenly, slowly, happily, unhappily, too soon. But to be dead — one either is or isn’t.

The same cannot be said of aliveness, of which there are countless degrees. One can be alive but half-asleep or half-noticing as the years fly, no matter how fully oxygenated the blood and brain or how steadily the heart beats. Fortunately, this is a reversible condition. One can learn to be alert to the extraordinary and press pause — to memorize moments of the everyday.

It is with such an appetite for aliveness that Dr. Sacks meets his own death when the unexpected diagnosis of the rare recurrence of a rare cancer interrupts the idyll of their love. But even this news he receives with his inescapable essence of a writer and a lucid optimist, a liver of life, underlining each word as he writes atop a new page of his notepad: “Sad, shocking, horrible, yes, but…” In one of the finest parenthetical passages I’ve ever encountered, replete with wisdom beyond its concrete context, Hayes explains:

(Oliver often said that but was his favorite word, a kind of etymological flip of the coin, for it allowed consideration of both sides of an argument, a topic, as well as a kind of looking-at-the-bright-side that was as much a part of his nature as his diffidence and indecisiveness.)

Beneath that underlined heading, Dr. Sacks lists what Hayes calls “eight and one-half reasons to remain hopeful; to feel lucky at the very moment when one might reasonably feel most unlucky.” His list would swell into his now-iconic essay on living and dying, “My Own Life,” which he dictated to Hayes almost fully formed over dinner a couple of nights later.

“My Own Life” by Bill Hayes

His life expectancy suddenly compressed by the terminal diagnosis, Dr. Sacks sets out to compress in turn as much life as possible into the time he has left, condensing even his very being to become all the more intensely himself. The seed for this zest, if fertilized by the diagnosis, had been there all along, captured in a prescient remark he had made to Hayes early in their love, years before the fatal illness, which appears as the book’s epigraph:

I don’t so much fear death as I do wasting life.

In another diary installment, Hayes captures the heart of what made Dr. Sacks such an exceptional writer — his adamant refusal to slide down the hierarchy of great writing from enchanter to mere explainer:

O, as he goes over final galleys for his book.

He insists on crossing out clauses suggested by a copy editor that define or explain an unusual word or term he has used: “Let them find out!” he says, meaning — make the reader work a little. Go look it up in the dictionary, or go to the library!

In a journal entry from the spring of 2015, Hayes records what might be an epitaph for Dr. Sacks:

O: “The most we can do is to write — intelligently, creatively, evocatively — about what it is like living in the world at this time.”

But what makes Dr. Sacks — the writer, the human being — so singular is the unremitting love with which he approached the world he attended to in writing, an orientation of spirit that calls to mind Mary Oliver’s assertion that “attention without feeling … is only a report.” Hayes captures this in a diary entry penned just two weeks before Dr. Sacks’s death:

[O:] “I say I love writing but really it is thinking I love — the rush of thoughts — new connections in the brain being made. And it comes out of the blue.” He smiled. “In such moments: I feel such love of the world, love of thinking…”

It is fair to doubt, as I did before beginning the book, whether it is possible to render a man so beloved by the world even more lovable. But this is precisely what Hayes has done, conveying with great care and tenderness the subtleties of character that only an intimate love can reveal in a person. There is, however, a harrowing price the reader must pay for bearing witness to their beautiful love: One is left to wonder how the loss of a man as irreplaceable as Dr. Sacks, a loss grieved by millions, is at all survivable by the person who loved him the most. And yet Hayes, in a supreme testament to how love teaches us to borrow the best parts of one another, tempers his melancholy with Oliver’s infinite capacity for buoyancy of mind and spirit. Half a century after Albert Camus’s abiding treatise on the most important question of existence, Hayes writes:

I remember how Wendy once told me she loved New York so much she couldn’t bear the thought of it going on without her. It seemed like both the saddest and the most romantic thing one could possibly say — sad because New York can never return the sentiment, and sad because it’s the kind of thing said more often about a romantic love — husband, wife, girlfriend, partner, lover. You can’t imagine them going on without you. But they do. We do. Every day, we may wake up and say, What’s the point? Why go on? And, there is really only one answer: To be alive.

“A Small Parade” by Bill Hayes

Insomniac City is an ineffably splendid read in its entirety, a mighty packet of pure aliveness. Complement it with Dr. Sacks’s own memoir of love, lunacy, and a life fully lived, the remarkable story of how music and literature saved him, and his beautiful, courageous farewell to the world.


Oliver Sacks on Evolving Our Notions of Normalcy to Include the Differently Abled

“If a tenth or a quarter of the population have some condition, it has to be accepted as a legitimate form of life.”

Oliver Sacks on Evolving Our Notions of Normalcy to Include the Differently Abled

“Color itself is a degree of darkness,” Goethe wrote in his theory of color and emotion. Although it was at bottom a misguided refutation of Newton, Goethe’s study of colors, in addition to inspiring artists and philosophers as wide-ranging as Schopenhauer, Gödel, and Kandinsky, inadvertently posed one of the most fascinating questions in neurology: What if color can, indeed, be experienced as degrees of achromatic darkness, and this mode of perception is not a disability but a difference in ability?

It fell on the irreplaceable Oliver Sacks (July 9, 1933–August 30, 2015), the Gödel of neurology and the Goethe of science writing, to answer that question.

Oliver Sacks (Photograph: Nicholas Naylor-Leland)

A voracious lifelong reader, Dr. Sacks had grown enchanted by the H.G. Wells short story “The Country of the Blind,” set in an isolated society where blindness prevailed for three centuries and where a lost Western traveller finds himself the aberrant one, afflicted with sight. Drawing on the Wells story, his own childhood experience of visual migraines that temporarily blunted his color perception, and his neurological work with a painter who had suddenly become colorblind, Dr. Sacks bridged two of his great literary and intellectual heroes — Wells and Darwin — and wondered whether there might exist, not in fiction but in geography, a real isolated culture where total colorblindness — or achromatopsia — had become a basic condition among the population.

Because such mutations are most easily contained in cultures isolated by sea, he reasoned that if such a society existed, it would have to be on an island. After tracking down the appropriate colleague to ask, he was surprised and thrilled to learn that one such island did indeed exist — Pingelap in the Caroline archipelago of Micronesia, where total colorblindness had been coloring the genetic pool for two centuries.

In 1993, tantalized by the promise of a real world that seemed fetched from his fancy, Dr. Sacks set out for Micronesia on a journey “not part of any program or agenda, not intended to prove or disprove any thesis, but simply to observe.” He recorded these observations in The Island of the Colorblind (public library), where they became, like all of his work at the intersection of science and literature, something much larger and richer than mere record — a wellspring of profound and poetic insight into the most central truths of the human experience gleaned from its most unusual and often stigmatized peripheries.

Pingelap, Micronesia

Like all genetic deviations from the mean, colorblindness on Pingelap had emerged due to a formidable brush with randomness. In 1775, a typhoon decimated 90% of the people living on the island. Most of the remaining survivors eventually succumbed to a slow death of starvation, so that of the one thousand islanders only twenty remained. Several centuries earlier, the original settlers had brought to Pingelap the recessive gene for colorblindness, but because the population had been large enough, the odds of two carriers marrying and the gene manifesting in their children had been fairly low. Now, with a tiny but fertile group left with no recourse but inbreeding to repopulate the island, the recessive gene suddenly flourished into growing domination and total colorblindness was soon a common condition.

When achromatopsia first appeared on Pingelap, the term maskun — local for “not-see” — was coined to refer to those afflicted. Two hundred years after the fateful typhoon, 57 of the 700 islanders were maskuns and an entire third of the population carried the gene for the condition. Total colorblindness manifested in one out of every twelve people — a gargantuan leap from the one in 30,000 precedence everywhere else in the world.

Dr. Sacks paints the unusual genetic backdrop against which this little-studied and therefore poorly understood culture plays out:

Colorblindness had existed on both Fuur and Pingelap for a century or more, and though both islands had been the subject of extensive genetic studies, there had been no human (so to speak, Wellsian) explorations of them, of what it might be like to be an achromatope in an achromatopic community — to be not only totally colorblind oneself, but to have, perhaps, colorblind parents and grandparents, neighbors and teachers, to be part of a culture where the entire concept of color might be missing, but where, instead, other forms of perception, of attention, might be amplified in compensation. I had a vision, only half fantastic, of an entire achromatopic culture with its own singular tastes, arts, cooking, and clothing — a culture where the sensorium, the imagination, took quite different forms from our own, and where “color” was so totally devoid of referents or meaning that there were no color names, no color metaphors, no language to express it; but (perhaps) a heightened language for the subtlest variations of texture and tone, all that the rest of us dismiss as “grey.”

When he hears of a vision researcher at the University of Oslo named Knut Nordby — a physiologist and psychophysicist who had made his personal condition, colorblindness, the area of his professional expertise — Dr. Sacks immediately knows that his Norwegian colleague would be the perfect companion for a trip to the curious island of the colorblind. The go went on to “form a team, an expedition at once neurological, scientific, and romantic,” and depart for the archipelago harboring the mysterious island.

Dr. Sacks soon finds that his colorblind colleague reaps the rewards of the visual world as much as, if differently from, the color-seeing majority. He writes of their arrival:

For us, as color-normals, it was at first just a confusion of greens, whereas to Knut it was a polyphony of brightnesses, tonalities, shapes, and textures, easily identified and distinguished from each other.

Indeed, Dr. Sacks and his companions discover that maskuns, especially maskun children, have adapted to and compensated for their condition in remarkable ways. Observing a group of schoolchildren, he writes:

The achromatopic children seemed to have developed very acute auditory and factual memories… [They] were oddly knowledgeable too about the colors of people’s clothing, and various objects around them — and often seemed to know what colors “went” with what… We could already observe in these achromatopic children in Mand how a sort of theoretical knowledge and know-how, a compensatory hypertrophy of curiosity and memory, were rapidly developing in reaction to their perceptual problems. They were learning to compensate cognitively for what they could not directly perceive or comprehend.

In this wonderful excerpt from a 1998 radio interview by Henry Tischler, uncovered and animated by Blank on Blank, Dr. Sacks relays the incident that illuminated for him the way in which the maskuns had transformed their condition not into a disability but into a different ability, one superior to his “normal” ability in surprising and humbling ways — an insight that applies as much to colorblindness as it does to conditions like autism:

There is a sort of critical level, so that if a tenth or a quarter of the population have some condition, it has to be accepted as a legitimate form of life and won’t be marginalized and, sometimes, won’t even be noticed.

The Island of the Colorblind is a revelatory read in its totality. Complement it with Dr. Sacks on death and destiny, the power of music, choosing empathy over vengeance, and his stirring recollection of his largehearted life, then revisit more Blank on Blank animated archival treasures: Leonard Cohen on creativity and his influences, Nora Ephron on women and politics, Kurt Vonnegut on what it takes to be a writer, Sally Ride’s conversation with Gloria Steinem about being a trailblazing female astronaut, John Lennon and Yoko Ono on the art of love, Ray Bradbury on the secret to great storytelling, David Foster Wallace on the dark side of ambition, Jane Goodall on overcoming extraordinary odds, Hunter S. Thompson on the only cure for our destructive tendencies, and Richard Feynman on what his father taught him about the most important thing.


Oliver Sacks on Death, Destiny, and the Redemptive Radiance of a Life Fully Lived

“It is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.”

Oliver Sacks on Death, Destiny, and the Redemptive Radiance of a Life Fully Lived

“To lament that we shall not be alive a hundred years hence, is the same folly as to be sorry we were not alive a hundred years ago,” Montaigne observed in his sixteenth-century meditation on death and the art of living. “The greatest dignity to be found in death is the dignity of the life that preceded it,” the late surgeon and bioethicist Sherwin Nuland wrote half a millennium later in his foundational treatise on mortality.

I am yet to encounter a human being who embodied and enacted these difficult truths more wholeheartedly than Oliver Sacks (July 9, 1933–August 30, 2015).

He confronted death directly, with courageous curiosity and radiant lucidity, in one of his New York Times essays posthumously collected in the small, enormously life-affirming book Gratitude (public library) — that great parting gift which gave us Dr. Sacks’s warm wisdom on the measure of living and the dignity of dying, edited by his partner, the writer and photographer Bill Hayes, and his friend and assistant of thirty years, Kate Edgar.

Oliver Sacks by Bill Hayes
Oliver Sacks by Bill Hayes

After learning of his terminal diagnosis, the irreplaceable Dr. Sacks peers into the depths of existence from the bittersweet platform of a long and, suddenly, immediately finite life:

I have been increasingly conscious, for the last 10 years or so, of deaths among my contemporaries. My generation is on the way out, and each death I have felt as an abruption, a tearing away of part of myself. There will be no one like us when we are gone, but then there is no one like anyone else, ever. When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.

As he faces the end of his own path — an end he had escaped narrowly decades earlier, when he saved his own life with literature and song — he writes:

I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.

Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.

Complement the thoroughly transcendent Gratitude with Dr. Sacks on what his beloved aunt taught him about dying with dignity and courage, his enchanting recollection of his largehearted life, and this remembrance of him written the day of his death, then revisit John Updike on writing and death and this wonderful Danish children’s book about making sense of mortality.


The Art of Medicine: W.H. Auden on What Makes a Great Physician and How He Influenced Oliver Sacks

“A doctor, like anyone else who has to deal with human beings, each of them unique, cannot be a scientist; he is either, like the surgeon, a craftsman, or, like the physician and the psychologist, an artist.”

The Art of Medicine: W.H. Auden on What Makes a Great Physician and How He Influenced Oliver Sacks

The poetry of W.H. Auden (February 21, 1907–September 29, 1973) was among Oliver Sacks’s formative books. When the two men eventually became friends in the final years of Auden’s life, Dr. Sacks was still a thirty-something neurologist with little more than a weightlifting record under his belt, a long way from becoming the Dante of medicine. Auden became an invaluable mentor as the young writer was honing the singular voice that would later render him the greatest science-storyteller of our time.

In the pages of A Certain World (public library) — Auden’s terrific commonplace book, that proto-Tumblr of fragmentary inspirations fomenting the poet’s imagination — I was delighted to discover the surprising seedbed of the kinship of spirit between these two otherwise rather different geniuses.


Under the entry for Medicine, Auden writes:

I can remember my father, who was a physician, quoting to me when I was a young boy an aphorism by Sir William Osler: “Care more for the individual patient than for the special features of his disease.” In other words, a doctor, like anyone else who has to deal with human beings, each of them unique, cannot be a scientist; he is either, like the surgeon, a craftsman, or, like the physician and the psychologist, an artist.


It is precisely those members of the medical profession who make the bogus claim that they are “scientific” who are most likely to refuse to consider new evidence.

Radiating from this private reflection is the sudden illumination of why Dr. Sacks, that poetic humanist of modern medicine, was so enchanted by Auden’s work and the spirit from which it sprang. (In my own life, I have found that all of my close friendships with people whom I’ve first encountered through their work are based on something larger than aesthetic admiration for one another’s work — they are based, rather, on a certain resonant affinity for the spirit undergirding the work, of which the work is only a partial expression.)

Dr. Sacks on the set of the cinematic adaptation of his book Awakenings, with Robin Williams, 1989 (Courtesy of Oliver Sacks)

Writing shortly before the publication of Dr. Sacks’s groundbreaking Awakenings — the record of his miraculous work with patients frozen in a trance-like state by sleeping-sickness, brought back to life in large part by music — Auden offers a beautiful figurative counterpart to Dr. Sacks’s literal solution:

As Novalis wrote, “Every sickness is a musical problem; every cure a musical solution…” This means that in order to be a good doctor a man must also have a good character, that is to say, whatever weaknesses and foibles he may have, he must love his fellow human beings in the concrete and desire their good before his own. A doctor, like a politician, who loves other men only in the abstract or regards them simply as a source of income can, however clever, do nothing but harm.

In his magnificent autobiography, which remains one of the most rewarding and life-expanding books I’ve ever read, Dr. Sacks recounts the advice Auden gave him as he was writing Awakenings:

You’re going to have to go beyond the clinical… Be metaphorical, be mystical, be whatever you need.

How marvelous to uncover, buried amid the pages of his forgotten commonplace book, the seed of this wisdom, which helped Dr. Sacks write the book in such a way that Auden himself would later laud as a masterpiece.

Complement this particular fragment of Auden’s altogether wonderful A Certain World, which also gave us the poet on writing and the most important principle in making art, with the story of how Oliver Sacks once saved his own life with music.


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