To restore the human subject at the centre–the suffering, afflicted, fighting, human subject–we must deepen a case history to a narrative or tale; only then do we have a ‘who’ as well as a ‘what’, a real person, a patient in relation to disease–in relation to the physical.
Here Sacks states the central purpose of his narrative work. Many scientific studies in the realm of the mind completely remove the humanity from their subjects, reducing them to the most basic character markers and traits. To augment a scientific case history into a semi-fictional narrative does not, in Sacks’ book, make it any less valuable. Rather, it is a far more humanistic and empathetic approach to discussing neurological disease; an element of the human condition that will ultimately affect us all.
‘Deficit’, we have said, is neurology’s favourite word–its only word, indeed, for any disturbance of function.
This quote encapsulates a central critique Sacks wages against his own discipline. It serves as a backdrop for much of Sacks’ focus in the first two sections of the book, as he addresses both the losses that neurology tends to miss and the excesses that at times undercut the foundations of the field. The quote also gets at a larger point about a general attitude science tends to have towards patients: that “faulty” or unconventional behavior is always considered to be a lacking quality in the patient’s composition, rather than an opportunity for gain in a new direction.
Here then was the paradox of the President’s speech. We normals–aided, doubtless, by our wish to be fooled, were indeed well and truly fooled (‘Populus vult decipi, ergo decipiatur’). And so cunningly was deceptive word-use combined with deceptive tone, that only the brain-damaged remained intact, undeceived.
Here Sacks unfurls a punchline of sorts at the end of his story about aphasia-ward patients laughing at a televised speech from the President. It highlights the fact that “normal” reality is composed of both schematically organized words, facts, and figures, and a litany of subtler images, movements, sounds, and rhythms that we combine together to form a unified concept of what we’re perceiving. The aphasia ward patients, no longer able to bring these perceptions together, have a unique line of sight that reveals to them something that no one else is able to see. This fortifies the argument that sometimes a neurological “deficit” is not necessarily a deficit at all.
Yeah, Doc, I’ve got it! I don’t need a mirror–I just need a level. I can’t use the spirit levels inside my head, but why couldn’t I use levels outside my head–levels I could see, I could use with my eyes?
This quote showcases the positivity and creativity that it takes for Mr. MacGregor to find a workaround to his strange neurological disorder. By proclaiming that he doesn’t need a mirror to solve his balance problems, he is saying that he will do no good by obsessing over who he has become and what his condition physically looks like. Instead, he chooses to build an external replacement for the internal balancing mechanism that he has lost. Rather than lament his condition, Mr. MacGregor’s constructive attitude leads to a solution that is genuine to who he has always been.
What a paradox, what a cruelty, what an irony, there is here–that inner life and imagination may lie dull and dormant unless released, awakened, by an intoxication or disease!
Here, Sacks laments the difficulty his patients experience straddling the expectations of society and their desire for an unfettered and joyous inner experience of life. By including the word “cruelty” in his assessment, he evokes the image of these diseases coming from a conscious, perhaps divine source. However, it also reminds us that even though his patients’ inner lives might be dull, they still contain a fantastic potential for growth and transformation. This is a common theme that runs throughout the book.
The final form of cerebral representation must be, or allow, ‘art’–the artful scenery and melody of experience and action.
This quote emphasizes Sacks’ idea that art is an expression of the life we have lived that no longer exists in our explicit memory. It justifies why Mrs. O’M and Mrs. O’C are plagued by music from their past, in place of visual memories originally associated with that song. The way they react to these tunes in their heads perhaps says more about how they feel about the forgotten memories behind the song than it does about the song itself. It is also the reason Sacks goes on to argue as to why art therapy can be a valuable tool for brain-damaged patients.
The final therapy, as Freud said, is work and love.
Here Sacks reduces the years of grueling and painful work it takes for Donald to move past his traumas and gradually build a new, positive life for himself. It downplays the importance of all the complex mental hoops his patients often have to jump through in order to reconcile with their disorders, along with the collapse of regular life that comes along. It also emphasizes that the ultimate needs of his patients are no different than the needs of anybody else: to be happily productive and to be loved by others.
In particular, as physicians, as therapists, as teachers, as scientists, we are invited, indeed compelled, towards an exploration of the concrete.
This quote inverts the popularly-held belief that intellectualism is exclusively about the exploration of abstract concepts and systems of thought. Further, it supports Sacks’ argument that “simple-minded” individuals hold the keys to many mysteries of the physical world. Unbothered by abstract and highly connective thought, those with autism and low IQs actually have a stronger and richer sense of the world as a non-abstract object. These claims are later developed by Sacks in his essays on specific patients with autism and other intellectual disabilities.
Grannie’s all right. She’s gone to her Long Home.
Here, Rebecca demonstrates her remarkable and even uncanny use of words. Although her demeanor is somewhat childish, her original conception of the “Long Home” as a metaphor for death is quite resonant. This builds on Sacks’ argument that although she has intellectual disabilities, Rebecca is no simpleton. Her process of grieving for her grandmother is just as emotionally and spiritually deep as anyone else’s. As someone who has long appreciated listening to stories, Rebecca has an intuitive sense for how words connect in symbolic frameworks to invoke unique and special meanings.
The autistic, by their nature, are seldom open to influence. It is their ‘fate’ to be isolated, and thus original.
This quote synthesizes the reasons why autistic individuals seem to possess a captivating quality of novelty and originality in the work they produce. It gives us a window into how Sacks conceptualizes the idea of originality. To be original is in many ways a double-edged sword; although it expresses one’s unique spirit and worldview, it also comes hand-in-hand with the feeling that there is no one else in the world who shares that spirit and worldview. We can see this quote in part as a reason why Sacks seems to have made a point of surrounding his writing with the perspectives and wisdom of others.
