Monday 31 August 2015

VALE OLIVER SACKS

In the early 80's, a decade in which I was basically constantly pregnant or nursing, I managed to find time between working and kids to browse bookshops (remember those?) and I chanced upon a small Pan paperback called Migraine. I was quite interested in the topic, as I had a friend from school (until today) whose migraine was a third person in the relationship and I had seen up close what it could do to a person's life. I had also seen some funny things as a doctor, and I had also experienced a few episodes myself, strange visual blind spots and shimmering, temporary inability to find words, and other slightly scary stuff, usually associated with a pregnancy.
So I bought the book and took it home.
I had done a bit of medical reading during my training but I had never read a book like this before. It was full of literary and historical allusions. It was not actually written for doctors in particular, that was clearly stated in the forward; it was also for sufferers of migraine. And it didn't just give over dry case histories, but fleshed out stories and descriptions, and then mused and philosophised over the stories and the patients. It was like nothing I had ever read. I didn't just learn about the different types of migraine; I learned about Hildegard of Bingen. (Could be her visions related to migraine!) Underpinning the whole style of writing was a deep intellectual curiosity and an attitude of seeing the malady not as The Enemy, but as an expression of the patient's actual being. The aim was not just to vanquish the problem, but to understand it and work with it along with the patient who was living with it.
The author had obviously really listened to the patients and really saw them, not just as sufferers in the consultation room, but as fully realised human beings, carefully and thoroughly,  even lovingly, you could say, described and depicted. It was a revelation. The book had been originally written in 1970 and had been revised in 1980.
The writer was Oliver Sacks.  I have to say that the name meant nothing to me.
About 5 years later I heard about and then bought the oddly titled The Man Who Mistook His Wife For a Hat. As soon as I started reading it, I made the connection. This book was easier, it made no effort with glossaries and index, it was purely stories. Case histories of patients with things that we used to think of as exceedingly rare, like Tourettes, or Aspergers. A deeper understanding of neural deficits caused by disease or alcoholism or trauma- and not just as deficits, but as part of the patient's story and journey through life.
Then I found Awakenings, and they made a movie of it, but by then I was completely hooked. A Leg To Stand On was a timely offering; my husband was recovering from a badly broken leg and someone gave it to him as a gift while he was recuperating- but I had already bought a copy. I don't know if it helped hubby but it certainly diverted him.
I own every book that Oliver Sacks published, the later ones in hardback because I couldn't wait for them to come out in paperback. His first autobiography, Uncle Tungsten from  2001, was an eye-opener. I had worked out that he was Jewish and related* to Rabbi Lord Jonathan Sacks (whom I also admire greatly), but the story of his childhood, his unusual and brilliant surgeon mother, who brought home an aborted foetus for him to dissect when he was about 12- can't get that little detail out of my mind- his clever extended family, including Abba Eban (yet another person I admire!)- it was riveting.
I didn't admire or agree with every single thing that he wrote; in Hallucinations from 2012, I was strongly struck by his complete atheism. In describing some hallucinatory experiences it was as if he was bending over backwards to reduce every described experience to a set of chemical events. There was no room for the spiritual in his narrative, and I found that fascinating. But as far as his compassion and sense of the patient's humanity was concerned, he remains a great influence on how I try to relate to my own patients.
He came to Australia on at least one occasion, because I went to hear him speak - I think it was the early 2000's- and to buy his latest book AND I took the opportunity of bringing my own stack of books for him to autograph as well.
All of them were published by Picador, except Migraine, the smallest book, on top of my pile. He picked it up and glanced at me with a smile, then showed it to his personal assistant. He signed all of the books in a semi-legible scrawl of green felt-tip pen; but Migraine he signed Oliver Wolf Sacks, because he was pleased to see it, his first literary offering, written when he was in his 30's. I guess it amused him.
For the record, he was a very shy man with a self-diagnosed inability to recognise faces (prosopagnosia - like me) or places (thus getting lost anywhere and everywhere- like me.) He lived alone and I guess he turned his love and affection on to his patients; it certainly felt that way when I read his books.
In his book The Mind's Eye, he described his own visual problems, which turned out to be due to a melanoma of the retina of his eye. I won't say that I am a prophet, but the diagnosis of malignant melanoma is too often a terrible one with a poor prognosis. And in the retina. It sounded bad when I read about it, and it turned out to be bad, because he passed away yesterday at the age of 82, from metastatic melanoma. His last essay, about the Sabbath, is a gently told story about growing up in an orthodox Jewish family, keeping Shabbos, until he broke away, partly because of his mother's rejection of the possibility that he was gay; the last paragraph is elegiac in tone and as sad and beautiful as any of his writings. But I didn't want to believe that it would be the very last thing he wrote.
I have his last autobiography, On The Move, next to my bed, next in line for reading. So I have a full set of his books; I should be pleased. But I feel as if a light has departed from this world.

RIP, Oliver Sacks. I know you didn't believe in Heaven, but I believe that you're there anyway. And if it turns out you were right, then you live on in your books and in the people you influenced.



*turns out he wasn't related at all to Rabbi Jonathan Sacks. I'm not sure where I got that info from but in On The Move OWS makes it clear that they are not family. 

Sunday 30 August 2015

FASTER AND FASTER

I cannot believe that I haven't posted since June. And you know what else I can't believe? It's Rosh Hashanah in two weeks. TWO WEEKS.

This is actually not possible, because wasn't it just Pesach a few months ago? And didn't I just write about RH a couple months before that? And isn't today Monday, so it's just been Shabbos, but it's nearly Shabbos again? What the hell is going on?

OK, yes, I'm busy, so that makes time go faster I guess. And yes, I am older, and the older I get, the quicker time passes because each unit of time is a smaller percentage of the time that I have already lived so it is perceived as a shorter interval. That's why, when you are young, it takes FOREVER for your birthday to come around. If you are 5, a year is a 5th of your life! That's a long time. But if you are pushing 60, like me, a year is only 1/60th of your life. So as I get older, the years will spin by faster than an Iranian centrifuge. And that's what we all have to look forward to.

There is some good to be found in this. For example, if I find myself stuck in something unpleasant or tiresome, like listening to a boring speaker or working out in gym, I just tell myself that it will all be over soon, because everything is over soon.

I have a manicure every 2 weeks, because when I became a grown up lady, some time after 45, manicures became compulsory. At first I had weekly sessions involving cleaning things up and lots of tsk-tsking from the manicurist, but as I got sucked into this desire to always have perfect nails, I eventually succumbed to the Biogel, so that needs maintenance every 2 weeks. It takes about 20-30 minutes of tidying up, infilling, painting yada yada and then about an HOUR of sitting there waiting for it to dry. (Of course, that hour passes in 15 minutes, so NP.) Only then do I go out and usually it all holds until the next session which is 2 weeks (i.e. 4 days) away.
So last session I sat and sat and then I went home and promptly got my thumb stuck in a drawer, which cause a scrape of the nail polish. Curses. One really does get obsessive about this stuff.
Daughter: 'Why not go back and have her fix it?'
Me: 'Because I do NOT want to be THAT sort of person.'
Daughter: 'I hear you.'
Me: 'And besides, it's almost time for the next manicure.'
Daughter: <silence> (But kind of judgmental silence.)

So I have got a bit of a leg-up on Rosh HaShana, because I have made a lot of chicken soup and even several containers of tzimmes, AND a honey cake, and it is all safely nestled in the freezer, along with the bulk order of meat and chicken from the butcher. So I'm feeling pretty pleased with myself about that. Except I haven't actually gotten around to inviting anyone to come for meals over Yom Tov, apart from immediate family. (But that ALWAYS happens because the butcher starts warning me about Pesach and Yom Tov at least 3 months before, which sends me into a mini-panic. I end up buying vast amounts of meat with no idea of who is actually going to eat it. And yet...it gets eaten.)

But as for the spiritual stuff, G-d help me. Every year, I feel less prepared. And before I know it, I will be sitting in my rarely-frequented seat in Shul, trying not to leaf through my machzor, counting the pages until it will be over. Because I know it will be over. It will ALL be over: Too soon.

Ksivah veChasimah Tovah, wishing for a year of good health, joy and peace. And living in the moment. (Unless the moment is unpleasant, in which case I will eat chocolate.)