Anyhow, thank you again for sending me your beautiful and careful study of Munnsville—and let us keep in touch.

  With kind regards,

  Oliver Sacks

  * * *

  —

  OS continued to wrestle with his piece about Stephen Wiltshire and his thoughts about autism in general, including Asperger’s syndrome—a type of autism then almost unrecognized except by a few autism researchers, and virtually unknown to the public. He went to Colorado to meet Temple Grandin, thinking the encounter might end up as a footnote to his piece on Stephen. Instead, it sparked a lifelong relationship, and a new essay that would become the title chapter of An Anthropologist on Mars. He also visited schools for autistic children and corresponded with many of the leading researchers.

  To Bernard Rimland

  Autism Researcher[*47]

  April 21, 1994 [Not Sent]

  299 West 12th St., New York

  Dear Bernard,

  Thank you so much for your nice letter of the 1st. […] This has been an oppressively busy time, not least because I keep writing and rewriting and revising and rerevising a long piece on Stephen Wiltshire (the autistic savant in London whom I am sure you know about). I have been finding it a most difficult piece to write—partly because I have known Stephen for many years (since ’87), partly because I am still not sure what his “inner life,” mental processes etc. are like—nor how he does his miraculous drawings (and, now, his music too). Perhaps also because the whole business of a savant prodigy going “public” raises delicate issues which one hesitates to discuss. However, the piece is in galleys now, and I hope it may appear in the New Yorker this spring.

  I went up to Williamstown last weekend, to see Jessy Park and her parents—they have such a loving (but realistic) understanding of her, and her art. I wish they would write another book—it is 25 years and more, now, since Clara wrote The Siege.[*48] I went up with Isabelle Rapin, who is a very old friend of mine, and had wanted to meet the Parks since she read it in the Sixties. Isabelle also read your book when it came out, and was recommending it to me in the Sixties; but, at that time, I had no interest in autism, and scarcely knew of its existence. […]

  For myself, I esteem all of you, who have spent so many years observing, pondering, writing about autism, although I am not unaware of some of the internecine dissensions between A and B, B and C, etc. etc.

  This was very much my feeling when I entered the Deafness world, and found so many brilliant people, with different perspectives and different angles, often in strong disagreement with one another. Equally with the Migraine world, the Tourette world, all the other worlds I have “visited” though I think Intellect, and Dissension, reach a special pitch in the Autism world!

  I have, for better or worse, never felt myself a primary worker in any of these fields—certainly not in Deafness, or Autism, perhaps a little bit in some others—and my own impulses are for synthesis and reconciliation of views (reconciliation is not always possible with people!), and a general eclecticism and empiricism. I also have a strong sense of the biological variability of many disorders, and thus of the (possibility of) variability in their treatments. When Gowers writes, in the 1890’s, regarding the treatment of migraine, “the measures that do good in one case will fail in another, apparently quite similar,” I think his statement still holds a century later. I suspect too that something similar may hold regarding Tourette’s syndrome, and Autism—that some patients will do well with some (medicational) measures, whilst others will show no response to them.

  I feel I may need to say all this partly because you have sent me copies of your own (and others’) observations on [vitamin] B6, magnesium etc, and some of your correspondence with Isabelle and others. I myself, as I have said, am not a primary worker here, and have had no experience of any of these biological interventions. My suspicion is that they may help some people with autism, but not others—but I have not reviewed the literature, nor do I feel competent to do so. It would obviously be very good all round if a broad clarification and consensus could be reached. I have no special feelings “for” or “against” any mode of treatment—whatever works, so far as I am concerned, works, and should be tried (even if the mechanism of its working is wholly unclear). [Certain] beans were a “folk-remedy” for parkinsonism for centuries—but only found to contain l-DOPA (and, indeed, to be the richest natural source of it) in the 1970’s. Digitalis and colchicum were “unorthodox” remedies for centuries—I think we are still uncertain why colchicine works. […]

  So, after all this preamble, you will understand that I have a neutral position, or no position, or an entirely open-ended position, regarding most of the advocated treatments of autism. I also have to say that my own interest is less in treatment and especially in looking at phenomena, and a life, and perhaps at various theories—this was even true of migraine (tho’ of course, when I saw a patient with migraine, I was prepared to offer the entire pharmacopeia, to say nothing of biofeedback, behavioural therapy, acupuncture and analysis). I do not have any patients with autism,[*49] and my experience here is, in a way, very limited. I have probably seen no more than half a dozen people with autism at any depth, whereas I have seen thousands with Tourette’s and migraine. […]

  I have rattled on, and must stop—but I felt a need to define this and that.

  With all my thanks again, and best wishes,

  Oliver

  To William Swann

  Psychologist

  May 16, 1994

  299 West 12th St., New York

  Dear Bill,

  Many thanks for your letter and two chapters, all enjoyed. I will reply relatively briefly, because I have a painful shoulder (indeed it will be operated on tomorrow), and typing is difficult. […]

  The “case” of Virgil is one of seven case-histories I am now putting together for a book,[*50] and (it seems to me) all of them, in their way, describe or intimate something similar—the transformation of identity forced upon individuals by sudden, profound sensory or neural insults or inputs. In the case of Virgil (as of so many such patients) […] the change is very difficult, tho’ a few, apparently, can change and adapt very well.[*51] […] Similar considerations, in a way, arise with enterprises to augment or restore hearing in the deaf—especially, now, with the development of cochlear implants. You may know Harlan Lane’s latest book here (The Mask of Benevolence, Knopf—originally, and perhaps better, entitled Let Me Be Deaf).

  Another patient, an artist who became suddenly totally colorblind in his sixties (a head injury), whose case I originally published in the NYRB in ’87 (but have now extensively rewritten) was able to “redefine” himself or adapt in a most creative way, to harbour the birth of a new Achromatopic sensibility and identity and creativity, after the color-normal one had been extinguished in him. But there was a terrible (and dangerous) interim between these, when […] he wandered between worlds—“one dead…one not yet ready to be born,” or whatever Matthew Arnold says in “Dover Beach.”[*52] And yet, “adapted” though he is, in a way, he cannot help looking back, wistfully, to time when his vision was full.

  Regarding the Awakenings patients, […] with someone like “Rose R.” the problem was far more radical, because her whole identity belonged to another period. There was none of the continuous evolution (for better or worse!) the rest of us have, and she had to “adapt,” or redefine herself, quite radically, with the medication, astonishingly. She failed, which is not surprising, but many of the others succeeded to some extent. […]

  There are so many examples of this sort of thing—indeed I think “medicine” or “the clinical” must itself be re-defined, so that it anticipates, discusses, and studies all such changes, and thinks in terms of “identities” rather than “norms.”

  Now I have selfishly ranted on about my patients and attitudes etc. and not properly “critiqued” yours—but, as I said, I am relatively ignorant of the social “shackles” you talk about so well (tho’ very conscious of the neural shackles instead). Both, obviously, are absolutely crucial.

  Thank you so much for sharing your work with me,

  Oliver

  * * *

  —

  In the summer of 1994, OS revisited Guam to examine the curious neurodegenerative disease endemic there, which so many scientists had tried and failed to elucidate over a span of decades. (In various ways similar to parkinsonism, to dementia, and even to ALS, it was regarded as a possible “Rosetta Stone” for neurological diseases in general.) He was accompanied by a BBC film crew that was making a series of six films called The Mind Traveller, based on OS’s work. They also visited the tiny, isolated atoll of Pingelap—OS had heard about a community of people there who were congenitally completely colorblind, or achromatopic (a neat contrast to the “colorblind painter,” whose achromatopsia was acquired late in life). Eventually, these travels in the South Pacific would lead to a book, The Island of the Colorblind, published in 1996.

  To Marcus and Gay Sacks

  September 9, 1994

  299 West 12th St., New York

  Dear Marcus & Gay,

  I have only just got back from my travels—to a huge backlog of mail, of everything; and, of course, your full letter of the 16th.

  The experience—of Pingelap, Ponape, Guam, Rota etc.—was enormously rich, and totally exhausting. It rained constantly, the temperature was always over 90 (often over 100), and the working days, all of them, were 16 hours long—so I had almost no time for myself, and would have had even less for anybody else. I think we did some grand filming in the Islands—there has never been documentation of the achromatopes of Pingelap/Ponape—and I hope I can recapture some of the experience in writing too, tho’ what with the filming, the exhaustion, the diarrhoea […] and the rain, I did not feel up to making many notes at the time. I hope the essential things are somewhere in my memory, and will come back when I try to tell the story.

  My shoulder—done in part arthroscopically, and part conventionally (acromioplasty, removal end of clavicle, repair of rotator cuff)—now feels very good, and I was able to do hard overarm swimming of a sort which had become almost impossible before. But, as you say, this is probably one of the many prices of my foolish weightlifting in youth. When I was in hospital for the second ruptured quad, in ’84, a former weightlifting friend of mine wandered by (with two hip replacements at the age of fifty)—and we agreed what fools we had been.

  You seem to have been having spectacular weather in Sydney—I wish I could catch that sort of weather when I was there, instead of the hot and sticky Februaries I seem to land in (and it will be that way, I guess, if/when I come to Canberra for the wedding[*53] in March). I hope the drought is not too serious—I remember how frighteningly brown Tasmania looked, Gay, when we flew there some years ago. […]

  Unlike you, I still use my (now 25 year) old IBM—and get it repaired when it needs it. I loathe the new typewriters—I like the pressure of the old keys, the way they bang, and stick—most pleasing. I remain among the few computer-illiterate people left—but Kate converts my writing/typing into beautiful word-processing (so I am spoilt). I also remain a two-finger typer—which was disabling when the shoulder was out.

  I had a memory (or is it a pseudo-memory) that Ma once showed me a model (or original) of our grandfather’s safety-lamp[*54] in the Science Museum in South Ken. Do you have a similar memory? I asked the Science museum about it, and they said they had no record but they were kind enough to send me the details of his patents. I enclose a copy of these for your amusement. […]

  So I will write again soon, but I did want to answer your own letter while it was fresh—and, of course, to wish you all the best of New Years.

  Do let me know wedding details as soon as you can, and if I can I will come over for it in March. […]

  All my love,

  Oliver

  To Antonio Damasio

  October 13, 1994

  299 West 12th St., New York

  Dear Antonio,

  It was a delight being able to spend time with you and Hanna in such congenial circumstances—I was very taken with the College, the “wholesomeness” of the mid-West (as you put it),[*55] and, of course, the incredible calibre of the Conference itself—an astonishing combination, as well as the relaxed way we could all chat informally into the early hours in the guest-house. What with this, and completing your book,[*56] I feel I know you a little better now!

  I don’t have the book with me as I type […] but I admired your discussion of “somatic markers,” and your general reflections on Embodiment immensely. I feel that this is what I have (roughly and inchoately) thought myself for years, but you give it an explicitness, a fullness, and a musing on possible neurobiological and neuro-evolutionary bases which is stunning. You have really written a book to be very proud of, and one which will surely play a very significant role in orienting and guiding thought/research in the future.

  The description and discussion of your frontal lobe patients—their complete loss of “secondary” emotions, with complete preservation of “primary” ones—was particularly fascinating (and I could not help wondering how much this might apply to some autistic people too). Luria, who plumbed the neuropsychology of such patients, would have been particularly enthralled by your observations/thoughts here—do you have separate articles on this?

  Had I read the second half of your book when I was in Minnesota I would not have said, impudently, that the “self” wasn’t being adequately considered. The heart of your book, I suppose, is that (in a way which is different from Gerry’s,[*57] but parallel, or perhaps convergent) you bring the “self” (as a continually-renewed construction—not a thing), and emotion, and the body (not just the brain) where it belongs, in the very center of neurology, and with such a wealth of clinical observation and other evidence as nobody now can gainsay.

  What would William James say now?

  My warmest regards to you and Hanna…and hopes to visit,

  Oliver

  To Brian Friel

  Playwright

  October 13, 1994

  299 West 12th St., New York

  Dear Mr. Friel,

  I have been reading Molly Sweeney with mixed feelings—admiration at its fineness (I think you are very gifted), and some disquiet at the unacknowledged way in which you have appropriated so much from my own piece “To See and Not See.”

  It is indeed a very creative use of my piece, as A Kind of Alaska was a very creative use of Awakenings; but where Harold Pinter sent me the manuscript, and noted (on its publication, and in its performances) that it had been “inspired” by Awakenings, you yourself have been somewhat less straightforward.

  I (and my Agents) will await your reply.

  Yours,

  Oliver Sacks

  To Brian Friel

  October 18, 1994

  299 West 12th St., New York

  Dear Mr. Friel,

  Thank you so much for your letter—I am delighted to have some personal contact with you, and only wish there had been some before your play was published.

  I did not know that you had cataracts in both eyes—my sympathy—and, of course, I well understand why this should have stimulated, and given a poignant personal interest to, your interest in seeing, blindness, and restoration of vision.

  I have admired your own work, and was especially fascinated to read your latest play, Molly Sweeney. I think it is a quite remarkable play, which brings out all the subtleties of experience and feeling as only a juxtaposition of stream-of-consciousness soliloquies could. I appreciate the formal similarities between it and Faith Healer, and the many resonances between the two plays. I perceive too how you have turned to seeing/not seeing as a metaphor—I too, though confined to the realm of clinical fact, am very conscious of the metaphorical potential of many of the cases I explore; and this, no doubt, is one of the reasons why my own case histories have had such special resonances for dramatists and others. This, finally, is why Awakenings was the inspiration of Harold Pinter’s A Kind of Alaska (as he was the first to acknowledge); and, I suspect, why you gave up your original idea of using [Richard] Gregory’s S.B. for your central character, and turned instead so massively to “Virgil.”

  Though you say that Molly is entirely fictional (I leave other characters out for the moment), and has no real antecedents except Grace Hardy, her personal and clinical history, as you give it in the play, is a virtual duplicate of Virgil’s. Molly, like Virgil, is a massage therapist; she is blind from early life with a retinitis and cataracts; she has first one cataract, then the other, removed in middle life, and following this is thrown into a state of agnosia and confusion; this is followed by episodes of impaired gnosis, then blindsight; and finally a strange reversion to blindness.