This suggestion at once bothers, frightens, pleases, and reassures me. I thought, first of all, when he spoke of “a change,” that he was going to dismiss me from treatment: “I’ve done all I can for you—now manage on your own!” I was then rather moved that after 20 years (!!) he should still consider me “worth” extra work. But then I was frightened at this confirmation (as I saw it) of the depths of my own superficialization and neurosis. Then excited at the notion that perhaps something was possible—when I had come to consider boredom-depression-loneliness-cutoffness-meaningless the “norm” and necessity for me, from now on: a sort of grim (occasionally ironic) “holding-action” until death put an end. Then alarmed again at the notion of what “the depths” might bring up. Then shoulder-shrugging, with the thought “Nu? So what have I to lose?” But what one has to lose, of course, may be just that quasi-stable if fragile “functioning.” So there is reason to hesitate, and, in any case, what with rushing here-and-there, London, California, Texas; with this nutty akathisia,[*18] NOTHING can be started. I must get back, settle down to dailiness/regular life in New York, before anything “deeper” is even physically possible, and this, in the nature of things, can’t be before the end of March.

  I don’t know why I have written all this—and very likely I will not post it. It does not merit or demand a “reply.” I am sorry to burden you with all this trash. But it is not so much to burden you as disburden myself. And perhaps some of it is due to, an artefact of, exhaustion, and the factitious life-weariness which this (like a migraine) can sometimes bring.

  I slightly fear leaving New York, leaving Shengold, as the corollary of my month in California. But perhaps Santa Cruz will turn out well. I will certainly strongly hope to see you out West.

  All my love to you and Kathy,[*19] the girls (women now), all your tribe.

  Love,

  Oliver

  * * *

  —

  The Man Who Mistook His Wife for a Hat was published in the United States in January 1986, with a modest first printing of about fifteen thousand copies. It received more attention than anyone expected for a collection of neurological case histories, thanks in part to a review in the daily New York Times, and it slowly began to find an enthusiastic audience. Still, OS’s publishers were surprised when it appeared on the Times best-seller list in March. It remained there for six months, and OS was increasingly deluged with correspondence from both fans and academics, as well as invitations to lecture.

  To Donald Campbell[*20]

  Correspondent

  April 19, 1986

  119 Horton St., City Island, NY

  Dear Sir,

  Thank you for your charming, open and friendly letter. I am glad you found all sorts of “resonances” in yourself to some of my Hat patients. Certainly (although I hope I have avoided any gross projections of myself) I could not have written them had I not felt something of their own “deficits,” “excesses,” dispositions, in myself. They represent extreme examples—pushed out of balance, perhaps—of elements we all of us have. Coincidentally I seem to have many of the peculiar strengths and weaknesses (but perhaps one should not use value-words like these) you describe in yourself.

  I do not know the “answer” to your particular conundrum—if, indeed, it requires one. (This too I share, at least in the allied art of “speaking,” I cannot prepare, or remember, anything—but, by God, I can improvise, at least if “mood,” atmosphere, etc. are favourable.) That you lack the “reportorial,” but have the “improvisational,” I think you should see as a gift—not a “conundrum.” I think that one needs to recognize and honour one’s deepest dispositions (which, in any case, one cannot change). One must be “oneself”—whatever this means!

  With kind regards,

  Oliver Sacks

  To Samuel Sacks

  April 21, 1986

  119 Horton St., City Island, NY

  Dear Pop,

  Sorry I have let so long elapse without a letter—I seem to have been constantly on-the-move, travelling, lecturing, getting distracted and exhausted.

  There are certainly two sides to this business of—being known, and suddenly finding oneself an object of ceaseless attention and demand. I begin to long passionately for peace and quiet—I receive at least fifty or sixty letters and phone-calls a day, and, if anything, this number is increasing!

  I WILL make up a parcel with lots of reviews, interviews, etc. but their number increases every day. I herewith enclose the latest best-seller list from the (New York) Times—as you will see, my book is now number 3! And a copy of an advertisement inserted in the Times last month, which will give you some idea of the widespread favourable opinions. But clearly, it is neither critical notice nor “marketing,” neither reviews nor interviews, which finally launch a book, but a sort of gathering murmur, mouth-to-mouth, in cafes and street-corners, in every corner of this immense land, a sort of deep resonance in the hearts of quite ordinary women and men, which makes these clinical tales, seemingly remote, so familiar.[*21] It is impossible to sell 70,000 copies (the number sold so far) without this deep and widespread emotional response—I get hundreds of letters (from North Dakota, Oklahoma, the most remote and far-out places) about “Jimmie” (The Lost Mariner), for example: he seems to have become a figure who means something to people, almost a friend, so I get dozens of letters asking about him, “How is Jimmie?”, as if they knew him, and wanted to know him. It really is a remarkable phenomenon.

  I find too (I am less happy about this) that countless people want to make plays, films, even operas and ballets, about my “characters”—thus there will be an opera about “Hat” (the title-piece) performed in London in June;[*22] there was already a sort of jazz-oratorio about “The Twins,” performed in Edinburgh and Glasgow (without my knowledge or consent); people want to make a ballet about “The Disembodied Lady” !! and so on. These secondary things have some power to bother and embarrass me, and I may take steps to prevent their coming into being; unless, of course, it is a work of high art—like Pinter’s. This too is very curious: I seem to have provided a stock of images—myths or fables for our time—and I thought I was merely writing simple case-histories! […]

  * * *

  —

  Erik (Korn) was just here from London, doing a bookfair here in New York. He is my oldest and dearest friend—and it is lovely to see him. Jonathan (Miller) is also here (and there), as mobile as myself, or more so, quick as quicksilver, I can’t catch him. […]

  I think/hope I will come to England next month. […] If I cannot make the Seder, I should make next month, and will try to get back to England for visits every few weeks or months. Certainly now I can afford to travel as I wish, and to take off time as I wish (except I feel anxious about leaving my patients, so it needs to be short, frequent travels, not extended ones).

  My best Pesach wishes and love to you and Michael, and all the family in England.

  Love,

  Oliver

  * * *

  —

  Though he continued his practice at the Little Sisters homes and elsewhere, seeing perhaps several hundred patients a year, OS had also become, in a way, neurologist to the entire world. Letters from readers and specialists continued to accumulate, and this became a rich extension of his medical practice, as people wrote to him about their own odd experiences. In early 1986 he received a letter from Robert Isaacson, a painter who had suddenly and puzzlingly lost all of his ability to see color. OS spent a good deal of the next few years investigating this with Isaacson, and eventually published an essay about him, “The Case of the Colorblind Painter.”[*23] This project marked the beginning of his engagement with a number of neuroscientists, and the growing use of new brain-imaging technologies such as MRI, fMRI, CT, and PET scans opened up whole new avenues for studying the brain in real time. People began talking of “neuroscience” as distinct from neurology.

  One reviewer, John C. Marshall, an English neurologist, reviewed The Man Who Mistook His Wife for a Hat for The New York Times Book Review on March 2, 1986. In an otherwise positive review, he expressed a single reservation:

  Dr. Sacks’ admirable presentation of seemingly bizarre phenomena and difficult concepts is marred by only one weakness. It is stylistic, but nonetheless extremely annoying. He constantly plays naive about the neurological literature. He would have us believe that an experienced neurologist could fail to have read anything about many of the standard syndromes of behavioral neurology until he had himself seen a particularly pure case of the condition in question.

  In fact, OS protested, his “playing naive” was probably more a product of his spending far more time with each patient than an average physician would, thereby uncovering a more nuanced picture. Often he was able to find descriptions of the odd syndromes he was seeing in long-forgotten papers from the nineteenth century, which he regarded as more detailed and thoughtful than the current literature. While some of these older papers would have been available in medical libraries, many of them came to OS from rare-book dealers who specialized in science and medicine.

  To Antonio Damasio

  Neurologist

  May 5, 1986

  119 Horton St., City Island, NY

  Dear Dr. Damasio,

  I have a bad (or good) habit: namely that I remain unacquainted with the neurological literature, bye and large, until a patient with a particular problem appears and excites my attention. Then (and only then) do I start to look for precedents and colleagues.

  Thus although I think I saw, in passing, some of your previous articles in Neurology on central achromatopsia, prosopagnosia, etc. they did not sink in, because I had never then seen a patient with such problems. Now, having recently been consulted by a fascinating and gifted patient, a painter, with rather sudden onset of achromatopsia, possibly preceded by some alexia, I have started to cast around me: and, of course, come upon your own superb article in Mesulam’s book—by far the clearest and deepest discussion of the subject I have seen (and, of course, the extraordinary brain-imaging illustrating your article).

  I am wondering, first, whether it would be possible for you to send me copies of your articles in Neurology 31, 32, 33, 34 and any others you may not have listed in the bibliography. Second, whether you have, or would advocate, any particular tests or “protocol” for the examination of such a patient. I should add that (in my own rather crude testing) I have observed deficiencies in gray-scale discrimination as well as total color-blindness (with no color-anomia or disorders of color-association that I can detect). Low-contrast differentiations are impaired, high-contrast ones exaggerated. There are some hints of prosopagnosia,[*24] if not in real life, then when given rather confusing and ambiguous pictures full of faces. He is an exceptionally intelligent man and is doubtless using inference far more than he realizes. Though greatly upset by his loss of color-vision, he is now doing some black-and-white painting, with a drama of contours, and modulations of hinted depth and movement, which are quite astonishing. Also, for the first time, some sculptures. After 3½ months, he is beginning to accept he may never recover color-vision (tho’ one hopes he may), but is turning with extraordinary creative intensity to the exploration of form, movement, depth. He has had CAT scans and NMR[*25] read as “normal”—is this consistent with his having genuine (associational) defects? Clinically, so far as I can judge, he is genuine, and I note you conclude that “the exact location and range of the lesions that can cause achromatopsia is a matter of current research.” Would a PET scan be useful? Have you other suggestions?

  I am sorry now I did not talk with you more in San Francisco, though I greatly enjoyed meeting you there, and was very conscious of an exceptional cast and calibre of mind. Indeed, I think I said something impertinent like “How come someone as intelligent as yourself is slated to talk about brain-imaging?” not realizing, or forgetting, your fundamental contributions to perceptual neuropsychology.

  But, of course, I had not then met this extraordinary patient.

  I would be most grateful for any thoughts on the subject you may be able to share with me.

  With kind regards,

  Oliver Sacks

  * * *

  —

  Francis Crick and James Watson famously discovered the double helix structure of DNA in the 1950s. Crick later turned to investigating the nature of consciousness, focusing particularly on the neural correlates of perception. His 1994 book, The Astonishing Hypothesis, would make the case that human consciousness could be entirely attributed to its neural activity, and proposed that the most tractable way to study this would be through focusing on the primate visual system. This research, of course, overlapped considerably with OS’s phenomenological investigations into patients with visual problems. At one dinner, OS sat next to Crick, and they discussed the colorblind painter and other visual-perception anomalies. Crick urged OS to send him more details.

  To Francis Crick

  Biologist and Neuroscientist

  May 30, 1986

  119 Horton St., City Island, NY

  Dear Dr. Crick,

  It was an extraordinary pleasure and privilege meeting you—a little like sitting next to an intellectual nuclear reactor! I never had a feeling of such incandescence—wonderful to have such a bright, sharp, laser-like mind illuminate problems and predicaments I see (but whose significance and explanation is quite beyond me).

  I would like (though I also fear!) to present some of these clinical observations on vision to people whose power to theorize so exceeds my own.

  I take the liberty (with some trepidation) of sending you Leg (the UK edition), which contains an account of how I (partially) lost, then recovered, stereopsis (pp. 119–120), and a (perhaps-too-ornate) account of a visual migraine, with “mosaic” and “cinematic” vision (pp. 66–70). Also an article (“The Great Awakening”), which preceded my book, describing some similar, and other, phenomena in l-DOPA patients.

  I was speaking to Dr. Damasio today, who told me he had seen you in Boston, and that you had mentioned my colorblind patient to him. I hope to film the patient (and some of his astonishing productions) this weekend (first for an NBC segment, then, hopefully, NOVA);[*26] and hope too that Dr. Damasio will be able to go over him in Iowa. It is a great privilege to encounter patients such as this—remarkable (and articulate) experiments of Nature.

  With my deepest respects, and best regards,

  Oliver Sacks

  * * *

  —

  OS describes in On the Move how he met Larry Perrier in a New York City gym in 1966. Larry was an unusual man who spent many hours each day walking long distances, often in flip-flops. When he visited New York, he often slept on OS’s couch.

  To Larry Perrier

  Itinerant Friend

  October 26, 1986

  119 Horton St., City Island, NY

  Dear Larry, old friend,

  I was so moved to get your letter—I don’t know that you (we) ever wrote before.

  Sorry I’m not answering sooner, but I have been finding life killing (rather than thrilling) with this tremendous barrage of attention, and hardly seem to have any time for myself (or my friends). The only real peace this year was a time in New Zealand, the sweetest and sanest place I’ve ever been (if my odd life has a “Part III” it may be there, or in Australia). The travels I’ve had to make are much less pleasant—but (lest I sound petulant) I have also been very warmed by the response to my book, and found a lovely welcoming wherever I’ve been, so it’s an odd and complex mixture. I do meet more people—in a way now I’m a “celebrity” (awful word!)—but this also emphasizes a sort of incorrigible aloneness and apartness. At least I think it’s incorrigible; though to my great surprise—for I had not had such feelings, I had thought my heart closed, for 20 or more years—I have felt a sweet tender feeling, a sort of mild “falling in love,” with someone just this month.[*27] I say nothing, I do nothing, I can see nothing coming of it, yet the sense of warmth (and imagined companionship) is like rain on my dry soil (I seem to be mixing my metaphors!). The feeling seemed to lend a special glow to the Fall colours when I went to Lake Jeff[*28] last weekend, and to remind me (what one sometimes forgets) that life can (or could) be deeply happy.

  Whatever the difficulties (which I don’t minimize), I think your continuing relation with Blanche crucial—you were so evidently transformed by it when I last saw you. (Even Helen[*29] remarks on this. She always asks about you, says, “He looked so good. He was a different man.”) So I don’t know whether, for either of us, it is “the same old story.” Some of it is old—but there is surely something new.

  And, as you say, it’s the Journey, first and last (with all the arrivals and departures, meetings and partings, any journey involves).

  I have some thoughts of getting another, larger house—perhaps (I have always loved it) that waterfront one, with the little cottage on its lawn, at the end of the street. If ever I can get it, the cottage is yours.