You stimulated your own brain in an attempt to unlock your creativity? What happened?
I was asked to draw a dog. I’m very bad at drawing. And my dog—well, it doesn’t quite look like an amoeba, but it’s a diagrammatic quadruped. It could equally well be an elephant or a mouse, pretty much. The experimenters wanted to see whether I might lose some of this abstract formulaic quality and draw an appealing dog in profile. Maybe if I’d stayed with it longer . . . but I was getting this peculiar sort of face ache. I don’t know why. It may be an idiosyncratic reaction. But certainly, there’s a tantalizing notion that such savant abilities may be universal or latent in all of us, and could be released in certain circumstances. But if the release entails a loss of enunciation—of our higher powers—it may not be such a good bargain.
Have you ever tried anything else to alter your brain function?
Well, I mention a rather autobiographic thing with amphetamines in a footnote in my new book—this is more than 40 years ago. [Sacks had experimented with massive doses of amphetamines.] I got into a very strange state for two weeks, a state in which I, who cannot draw, found myself able to do the most accurate anatomical drawings. I have a notebook from that time full of anatomical drawings of a sort I had never done before and have never done since. This also affected things like musical reproduction and sense of smell. I could recognize most people and most places by smell. And so I did have an experience myself of having various perceptual powers released. When it all disappeared, I had mixed feelings. It was a great relief, and also some regret. However, I think the amphetamines are terribly dangerous, and I’m glad I survived that time.
Some critics suggest that you romanticize your subjects—that you write sentimentally, even joyously, about some very sad cases. Why do you focus so much on the positive?
Well, I want to draw attention to it, but it’s there with the negative. In the old-fashioned medical notes, one would write about the HPC, or “history of the present complaint.” The patient comes to a doctor because something is the matter; they have a complaint. And one goes through it with the patient, but one also wants at the same time to remind them of the powers which are preserved and which they can perhaps use and which can mitigate life. My interest is very much in rehabilitation. I won’t say “recovery.” And maybe rehabilitation sounds rather technical, but it’s making the fullest possible life under the circumstances.
One of the most dramatic examples of music and rehabilitation comes in the story of your patient Clive. Can you describe this case?
Clive was an eminent musician and musicologist in England. In the mid-1980s he had a rare form of encephalitis caused by a virus, a herpes encephalitis. This caused massive destruction to various parts of his brain, but especially the temporal lobes and the hippocampal system, which is crucial for personal memories. As a result, when Clive recovered from the high fever—an acute symptom of the illness—he was profoundly amnesic; that’s to say he could not remember anything said to him or anything which happened in front of him for more than a few seconds, and there was also a retrospective deletion of memory. So what had happened for many years preceding this illness, and to some extent throughout his whole life, was gone. In a sense, he was a man without a memory. As such, he seemed utterly devastated and not there, very terrified and disorganized. But it was discovered by his wife, Deborah, who is also a musician and had been in his choir, that his musical sense—his ability to recognize and perform music at the highest professional level—was completely intact. He was able to sing, to play the piano, to conduct an orchestra or conduct a choir beautifully. So here is a paradox: The memory of events had been practically wiped out, whereas the memory of how to perform was completely intact, and in particular, how to perform music. He remained at a virtuoso level—it’s still the situation more than 20 years later.
Your chapter on Clive is strangely uplifting because he seems so happy when he conducts. That paradox really comes out in your book.
Clive was—I was going to use the F-word. Clive was tragic. One can pick out the high points, but he’s been wiped out in so many ways. I mean, mercifully, there is the music. . . . I hope I don’t romanticize unrealistically.
I think my business and the business of the physician is, one way or another, to try and help someone live—live realistically.