Oliver Sacks On the Move“I am a storyteller, for better and for worse. I suspect that a feeling for stories, for narrative, is a universal human disposition, going with our powers of language, consciousness of self, and autobiographical memory.” —Oliver Sacks, On the Move

Oliver Sacks has been many things in his life—physician, writer, researcher, drug addict, power lifter, motorcycle lover. He writes about all of these experiences as they have arced across the course of his much varied life in his memoir, On the Move [Amazon]. In this colorful autobiography, Sacks bobs and weaves through his own life, at times focusing in on the smallest detail, and at others zooming back for the 10,000 foot benefit of hindsight. Parts of the book are starkly innocent, while others border on frank arrogance. He demonstrates a complexity of personal characteristics that is at once believable and larger-than-life.

Book Overview

On the Move opens with a description of his childhood in England and his early love affair with motorcycles. After many decades of sidestepping the question, here Sacks openly writes about his sexual orientation and his subsequently conflicted relationship with his mother. Shortly following his years of university and medical school, he travels across the Atlantic to Canada in order to avoid the draft. Once there, he spends the first three months traveling west and lands unexpectedly in San Francisco, where he suddenly feels as if he has finally arrived home. He spends much of the next few years of internship and his neurology residency riding his motorcycle back and forth across the country and becoming intensely involved in power lifting. He experiments with stimulants and hallucinogens and rapidly becomes dragged down into a cycle of drug addiction while continuing to maintain his clinical practices—and of course, to write.

Sacks peppers his story with anecdotes from his patient encounters that continue to haunt. One patient, Frank, a man who initially confounded Sacks with his degenerative neurologic disease, dies ominously in an accident and becomes available for autopsy shortly after Sacks wished that he could see into the patient’s brain. Sacks also tells us about the many friends and colleagues who touched his life, both famous and not so famous. He writes about his brother Michael, who suffered greatly from paranoid schizophrenia during an era prior to the widespread use of antipsychotic medications. He discloses his few brief and sometimes passionate love affairs. However, his most touching relationship is with his Aunt Lennie, who seems to have given him a confidence that his successful parents had failed to instill.

Following residency, Sacks moves to New York City to complete a fellowship in neurochemistry and neuropathology at Albert Einstein. His raging drug abuse follows him across the country, where it almost kills him until friends intervene and pull him back from the brink. He begins work as a neurologist and publishes his first book, Migrane. The next several years of his career in New York City are tumultuous by any standard. Sacks is fired from three different jobs and intersperse his paid and unpaid time with postencephalic patients, autistic patients, and those with Tourette’s syndrome. He begins to make a name for himself with the publication of Awakenings, A Leg to Stand On, and the Man Who Mistook his Wife for a Hat. His circle of acquaintances grows to include well-known names such as the writer Thom Gunn, Francis Crick, Robert DeNiro, and the Nobel laureate neuroscientist Gerald Edelman. Sack also deals with the deaths of both his mother and father back in England.

Sacks concludes his memoir with a final chapter entitled, “Home.” As readers, we finally experience a sense of rest—or at least contentment. Sacks admits to feeling guilty for leaving his home country so abruptly in his early years, never to return again to live, and the absolution given to him by the Queen of England in his later years. He writes about his declining health and mortality. He also writes about the unexpected joy of meeting his partner, Bill Hayes, after 35 years of celibacy. Finally he reflects upon the act of writing itself. “The act of writing, when it goes well, gives me a pleasure, a joy, unlike any other … Over a lifetime, I have written millions of words, but the act of writing seems as fresh, and as much fun, as when I started it nearly seventy years ago.”

Analysis and Clinical Application

“To clinicians, Sacks generally seems a very good writer, and to lay readers, he often seems a remarkable doctor, but the extent of his distinction in either area has been subject to question. His writing sometimes has a tinge of expose, and there is no evidence that his clinical skills outrank those of other neurologists. To dismiss him on these fronts, however, misses the central fact that translating between those two great arenas has great value of it’s own.”

—New York Times Sunday Book Review

Oliver Sacks may be a neurologist by training, but On the Move reads like he should have been an emergency physician. Passionate, restless, and intensely curious about the world, we can certainly relate to his perspective on medicine, patients, travel, love, family, and friendships. The book unfolds like one of the author’s well-known case studies—except that the subject here is Oliver Sacks himself. He seamlessly weaves in his own colorful story with that of his many patients over the years and captivates us within the first few pages. He touches on some of the fundamental personal challenges of our field. Sacks writes “I thought of in part as a need to have different selves for day and night,” in describing how to marry his perception of his work self and personal self when first starting his career as a physician, a relatable struggle for many physicians.  An avid motorcyclist, he initially saw this as inconsistent with a respectable physician which he later proves wrong with his successful career as an esteemed neurologist. However, those accolades did not come without trials and challenges.  Sacks delves into darker moments in his life, including his struggle with drug abuse and addiction. He lets us in on how drug use affected his relationships and his work and a struggle that historically is taboo to discuss openly.

Then he reminds us of why we are in the medical field. Amidst the twists and turns of his extra curricular travels and adventures, he describes those memorable cases that stick with you for years. Academically, his insatiable curiosity and passion for learning brings the cases he describes to life and illuminating the fascinating science behind it almost making you want to exchange Sacks’ book for a pathology text. Almost. But patients are not just cases. His compassion for patients is apparent, even in defiance with professional norms. Sacks described a patient, suffering with a terminal disease. Her last wish was to join him on his motorcycle for a ride. In this moment, his dual identities come together as he makes the dying wish of his patient come true. He returned to the hospital, however, to be scolded, his job threatened, for his empathetic and unconventional act. It is clear, for Dr. Sacks, his patients come first.

Sacks’ innate desire for knowledge expands beyond the bounds of his chosen field and at times, the reader needs reminding that he is a neurologist. Reading from the perspective of an emergency medicine physician, you almost wonder, would Oliver Sacks be an emergency physician were that a specialty at the time of his training? While we will never be able to answer that question, a sense of reassurance in our own field comes from reading of his fascination of disease and treatment in many forms, which our field allows us to study. Not only is his fascination with his field apparent, but his respect of the history of medicine is clear as well. He describes the frustration of his colleagues during residency who rolled their eyes at his desire to discuss historical cases. Perhaps at the next educational conference, we will listen with a kind ear to that one colleague known to chime in with the seemly irrelevant knowledge or historic study.

Throughout his autobiography, Sacks returns to the power of narrative and storytelling in his own life but also its application in the field of medicine. He realizes that the practice of medicine is not just science, but is the art of the human story. We are reminded that in order to truly heal, we must understand more than simple physical complaints. Every day as emergency physicians we listen to and recreate dozens of stories as told to us by our patients and their families. And even beyond patient stories, sharing our own personal struggles and triumphs lets us know that we’re not alone. Stories make us resilient. They bind us together. They connect us to the patients we serve. They keep us human and reaffirm our commitment to making a difference in the lives of others. In the telling of his personal struggles, tragedies and triumphs, Sacks not only lets us in to his life but gives us a model and a platform to tell our own stories, find confidence in our strengths and, more importantly, our weaknesses. Not only did he advance the field of neurology, Sacks has advanced and challenged the concept of the physician.

Discussion Questions

  1. Although it was “understood” that Sacks would eventually become a doctor, he certainly did not take the direct path to respectability as was expected by his family. Reflect on your own path to choosing emergency medicine.
  2. Sacks delves into many of the important relationships in his life. Thinking back, who were the most influential people in your own life?
  3. The author describes attempting to delve into bench research two separate times, both ending in perceived failure. When have you felt failure in your career in medicine? How did those instances contribute to the physician you are today?
  4. Out of curiosity, Sacks used recreational drugs which evolved into a chronic abuse. Have you or have you known someone within the medical field who has struggled with drug abuse or addition? Do you feel as though he or she was supported by colleagues in recovery? Do you feel that this continues to be a taboo topic to discuss in the medical field?
  5. What are the activities outside of medicine that bring you joy?
Arlene Chung, MD

Arlene Chung, MD

Chief Strategy Officer,
2016-17 ALiEM Wellness Think Tank
Assistant Professor of Emergency Medicine
Assistant Program Director
Mount Sinai Emergency Medicine Residency
Editor, AKOSMED (EM wellness blog)
Arlene Chung, MD

@ArleneSujin

Residency Director @Maimonides_EM | @NYACEP Board of Directors | Chair, ACEP Well-Being Committee | Intrepid searcher for harmony | Opinions my own
Moira Carroll MD

Moira Carroll MD

PGY-2 Emergency Medicine Resident
Mount Sinai, New York
Moira Carroll MD

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