November 2017

Arts & Letters

The shape of a generous mind

By Kate Cole-Adams
Oliver Sacks’ brilliant ideas echo on through ‘The River of Consciousness’

“Two weeks before his death in August 2015, Oliver Sacks outlined the contents of The River of Consciousness, the last book he would oversee, and charged the three of us with arranging its publication.” So begins the foreword to the acclaimed neurologist’s most recent book.

What went on in those conversations in Sacks’ New York home – with his assistant Kate Edgar, editor friend Daniel Frank and partner Bill Hayes – we don’t discover. But in an essay penned in the days after he received his terminal diagnosis (and published elsewhere), Sacks plotted the new co-ordinates of his existence and described the view they afforded him. “Over the last few days, I have been able to see my life as from a great altitude, as a sort of landscape, and with a deepening sense of the connection of all its parts,” he wrote in ‘My Own Life’.

The River of Consciousness (Pan Macmillan; $32.99) is a product of that high vantage point. It is a series of essays that spans from the mid ’90s till shortly before Sacks’ death. Much of it has appeared in print before, often in the New York Review of Books, but some pieces have been edited and slightly expanded. This collection demonstrates a breadth of interest and erudition far beyond the medical and neurological for which Sacks is best known. Beyond that, and throughout, is a sense of connecting things up. Through the prism of Sacks’ abiding fascination with the question of consciousness, we are invited to consider the shape not of a life but of a mind.

It begins not, as you might expect, with Sacks, but with one of his great inspirations, Charles Darwin – albeit in an unfamiliar incarnation. Best known as a chronicler of finches, and the author of On the Origin of Species, Darwin’s work as a botanist has been less recognised. (“Darwin interrogated orchids, interrogated flowers, as no one had ever done before …”) Outlining Darwin’s extensive, exhaustive research on plant reproduction and adaptation, Sacks introduces us to themes that will eddy and flow throughout this gentle, fascinating collection: evolution in its various forms, the value and vicissitudes of science, and the vital, intimate engagement that connects scientists across space and time. And he introduces us finally to himself: a small boy in the family’s London garden, intoxicated by the scents and colours of flowers, the trajectories of the bees. (“It was my mother, botanically inclined, who explained to me what the bees were doing, their legs yellow with pollen, and how they and the flowers depended on each other.”) The sheer wonder of it all.

The same child’s-eye perspective breezes us into the next essay, an immersive sensory meditation on speed and motion, cinematography, and the subjective experience of time. We encounter HG Wells, philosopher William James and neuroscientist Christof Koch (whose work on the mechanics of consciousness intrigued Sacks). Zipping through the deviations and revelations of near death, epilepsy and LSD, we land at last in Beth Abraham Hospital in the Bronx. Here dwell the patients we first met in Sacks’ book Awakenings, who, having survived the great sleeping sickness epidemic of 1917–28, now exist in a “landscape of disordered time”. Sacks ushers us deftly through a medley of thinkers, theories and thoughts. He intertwines musings on the relationship between the brain, the mind and time with observations about the temporal distortions of patients with Parkinson’s disease and Tourette syndrome, and the possibilities of today’s super microscopes and telescopes. It’s terrific.

The next piece brings us back to Charles Darwin, now contemplating the mental lives of worms.

One of the pleasures and surprises of this collection is how seamlessly these discrete essays seem to flow into each other. This is a volume you can dip in and out of, but which rewards sequential reading. About halfway through ‘Sentience: The Mental Lives of Plants and Worms’, I became aware of a sort of pulse starting to push up through the book. An echo, perhaps, of the rhythmic pulsations of the jellyfish Sacks ponders, with their hunting behaviours and survival strategies, and the deeper questions that churn beneath them: at what point does a nervous system become a brain; a brain, a mind; a mind, conscious?

Much of the delight here derives, as always, from Sacks’ own delight in the subject matter and in his fellow creatures – particularly the thinkers and researchers whose painstakingly recorded investigations and big daring questions have anchored and oriented his own life’s work. “I was charmed by Romanes’s personal style,” he writes of evolutionary biologist George John Romanes who spoke about pursuing his studies of the minds of jellyfish, starfish and sea urchins “in ‘a laboratory set up upon the sea-beach … a neat little wooden workshop thrown open to the sea-breezes’.”

Sacks is frank in his admiration of his 19th-century predecessors. He mourns the loss of their richly descriptive methods of investigation, and this book is in part an extended, affectionate conversation with long-dead companions-in-thought. Chief among them are Darwin, Sigmund Freud and William James, with whom Sacks shares a faith in the power of narrative to capture experience and impart meaning.

The young Freud (“already a passionate Darwinian”) first appears in The River of Consciousness in a Viennese lab. There he is investigating the cellular structure of a primitive fish, the lamprey, which he shows (counter to prevailing beliefs) to be pretty much the same as for a crayfish or, by extension, you and me. (The difference, it turned out, was not in their structure but in the complexity of their organisation.) Freud’s first career as a neurologist – and his gradual abandonment of the hope of working out which bits of the brain were responsible for which psychiatric states – forms the basis of the next essay, ‘The Other Road: Freud as Neurologist’. This is one of three pieces in the collection that I could not find published previously, and allows Sacks to mark out ideas that he circles for the rest of the book: the evolution of scientific thought, the neural substrates of mind and consciousness, the nature of memory and forgetting.

The most clearly autobiographical material comes in the middle of the book: four essays that explore the fallibility of processes (memory, hearing, life) that we prefer to take for granted. They culminate in a short and wonderful piece, ‘A General Feeling of Disorder’, one of several that Sacks worked on in the weeks before he died. Bill Hayes, in his own recent memoir, Insomniac City: New York, Oliver, and Me, describes a morning conversation in which the ailing Sacks

… with his eyes closed as if seeing the pages in his mind … proceeded to describe in the most careful detail the workings of the autonomic nervous system, gradually zeroing in on the topic of “a general feeling of disorder,” a state the body enters when the smallest change – whether intestinal, vascular, hormonal, neurological, cellular, “what have you” – triggers a “cascade of unwellness.” … He hardly took a breath for thirty-five minutes.

When reading Sacks, there is always the sense of being with an expansive, generous mind. Even so, I was disconcerted less than a third of the way through, at having to remind myself that I did not actually know the man. While I get that the Sacks who leads us through these pages is not the Sacks who inhabited his own physical and emotional space in the world, the engagement with Sacks the thinker and writer is compelling. What, he wonders, might some future brain monitor reveal about the nature of creativity and the “gorgeous clarity and meaning” that flow through him in this state. At such times, he writes, “I feel I can bypass or transcend much of my own personality, my neuroses. It is at once not me and the innermost part of me, certainly the best part of me.”

And, while attuned to the specificity of lived experience, this is primarily a book of ideas: Sacks’ own and, at least as importantly, other people’s taken in and filtered through his own unique consciousness.

There is a small but telling change to the title of the essay from which this book takes its name. First published in 2004 as ‘In the River of Consciousness’, the piece has now lost the “in”. And there is a sense in the final two essays (this one and ‘Scotoma: Forgetting and Neglect in Science’) of Sacks moving up and out of himself, to occupy that higher ground. ‘The River of Consciousness’ returns explicitly to one of his central preoccupations: how does a tangle of neural matter give rise to the seamless subjective experience of human consciousness? This tantalising search (“the most fundamental and exciting adventure in neuroscience today”) suggests that the waking life we routinely experience as a flow is in fact a collection of discrete units, like photographic stills, that we construe in every moment into the cinematic – and deeply personal – experience of consciousness.

There is in all this a recognition of the provisional or fragmentary nature of processes and structures that we tell ourselves are solid. And in this context, Sacks’ decision to finish the collection with a piece from nearly 20 years earlier functions as a plea, or warning, to coming generations of thinkers, doctors and scientists. Like consciousness, the history of ideas tends to present itself as a continuum or “majestic unfolding”. But Sacks’ own research, and that of others, suggests otherwise. As with plants and animals, the evolution of ideas is dotted with dead ends, paths not taken. And, like consciousness itself, science is prey to memory lapses, distortions and evasions. Sacks wonders if, in our adherence to “comfortable, reductive” explanations in modern science, we risk fragmenting and missing information that may seem irrelevant now, but which might prove critical to future generations – and indeed our own.

Writing on contemporary approaches to the study and treatment of Tourette’s, he notes: “This sort of fragmentation is perhaps typical of a certain stage in science – the stage that follows pure description. But the fragments must somehow, sometime, be gathered together and presented once more as a coherent whole.”

Which is pretty much what Sacks has done here. Gathered his fragments – from the evolution of flowers to that of human knowledge – and presented them to us as a coherent and eloquent whole: one that might endure and evolve long after the extinction of the self.

Kate Cole-Adams

Kate Cole-Adams is the author of Anaesthesia: The Gift of Oblivion and the Mystery of Consciousness.

© Sueddeutsche Zeitung / Alamy

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