In 1960, Oliver Sacks, a 27-year-old University of Oxford graduate, arrived in San Francisco by Greyhound bus. Born in Cricklewood, London, Sacks spent the better part of his 20s training to be a doctor, but came to feel that English academic medicine was stifling and stratified. A “tight and tedious” professional ladder, he thought, was the only one available to aspiring neurologists like him.
A young queer man with a growing interest in motorcycle leather, Sacks had other reasons to leave. The revelation of his sexuality had caused a family rift: his mother felt it made him an “abomination”. And so he looked for escape across the Atlantic. America, for him, was the wide open west of Ansel Adams photographs; California was Steinbeck’s Cannery Row. The new world promised “space, freedom, interstices in which I could live and work”. This is how we meet Oliver Sacks in Letters: as an immigrant undertaking an internship at Mount Zion hospital, the first step in a career on US soil that would span another five decades.
Sacks’s San Francisco years also marked the beginning of his life as a writer. The city wasn’t an arbitrary choice. As he eagerly confessed to a one-time lover, Jenö Vincze, his true motivation for travelling to California was to force a meeting with an artistic idol, the British-turned-Haight Ashbury poet, Thom Gunn. Gunn’s The Sense of Movement (1957) spoke to and stirred Sacks’s predilection for motorbikes. Moreover, it performed on Sacks the kind of private miracle only poetry can: it helped decode “the babble” of his emotional life. “There is a queer, colossally big London Jew called Wolf,” Gunn wrote to his partner in 1961, after first meeting Sacks (who used his middle name, Wolf, as a nom de guerre when frequenting the city’s gay bars, wise to its lycanthropic resonances). “[He] came out to be a doctor here because I live here.” Sacks shared his writing with Gunn, whom he found a ruthless but tender critic, later crediting the poet with first impressing on him that he had real literary talent; a pivotal moment for a man who would go on to publish a dozen books.
“I am not a good correspondent,” Sacks wrote to his parents in 1961, “because I speak and write at people rather than to them.” This is an apt summation of Letters: 52 years of outgoing mail sent (or left unsent) to family, friends, scientists, writers and later, fans and celebrities, a panoply of addressees as diverse as the subjects Sacks writes “at” them about. Unleashed in a self-described “volcanic logorrhoea” that typifies his writing style, these letters variously consider botany, etymology, entomology, geology, neurology, and literature; the tussle between xenophobia and xeniality in Star Trek; the “phantasmagoric-comic unconscious” of actor Robin Williams. Edited by Kate Edgar, who worked as Sacks’s editorial assistant for over 20 years, Letters represents a mere fraction of the total in his archives, which runs to more than 200,000 pages.
Many of the included letters are incomplete, with ellipses denoting gaps whose editorial logic we must take on faith, even when they occasionally appear to interrupt tantalising trains of thought. In a 1984 letter to Lawrence Weschler, for instance, Sacks’s conflicted reflections on strike action in hospitals that might put vulnerable patients at risk feel prematurely curtailed. Despite these excisions, Letters leaves one with the overwhelming impression of a brilliant and vivid mind, a man whose intellectual appetite was vast, and whose professional and creative passions – far from being the self-absorbed obsessions of a pedant – were first and foremost an act of reaching out, the means through which he sought to communicate with others, a “love affair with the world”.
Sacks is an endearing and entertaining prose stylist – inquisitive, often funny, never obtuse – and the organisation of Letters, separated into broadly thematic, chronological chapters with concise editorial introductions, provides narrative momentum. The resulting book is far more engaging than the unwieldy reference text for Sacks specialists it could have been. It might, in fact, serve as a more affecting autobiography than his On the Move (2015), which occasionally slides into sentimentality. Letters is crammed with off-the-cuff profundities, moments of elevated perception that briefly unriddle the more inscrutable aspects of human nature. Here he is on grief, after the passing of his mother in 1972, an emotive state he deems “so unlike depression: it is so filling and real and expanding and uniting and – (it sounds an almost blasphemous word) – nourishing”.
Letters also draws an illuminating line from Sacks’s neurological career to his unlikely emergence as a bestselling author. In the late 60s, having relocated to New York, Sacks treated a group of patients suffering from encephalitis lethargica, also known as “sleeping sickness”, with an experimental drug, L-dopa. This experience informed his second book, Awakenings (1973), which married scientific research with storytelling through case studies of his patients’ lives and their responses to the treatment – a hybrid genre that irritated his colleagues just as it struck a chord with general readers. The literary attention Awakenings received set Sacks on a course to public renown.
“Brevity has never been a quality of mine,” he wrote to Mrs Miller, a physical therapist who helped him regain mobility after a leg injury in 1974. Indeed superabundance – the instinct toward excess – is everywhere in these letters. As a man of 30, dallying with powerlifting, Sacks routinely bragged to his parents about his weight, how much he could lift, the amount he ate – “I love to shake the pavement as I walk, to part crowds like the prow of a ship.” At Mount Zion, special scrubs had to be made to accommodate his bulk, and he found himself in disfavour with his superiors for stealing patients’ food.
But his overconsumption wasn’t always dietary. During the following 10 years or so, Sacks took a prodigious amount of amphetamines and psychotropics – “every dose an overdose” – with one trip producing visions of the “neurological heavens” so intense it inspired him to write his first book, Migraine (1970). By the 80s, following Awakenings and an appearance on The Dick Cavett Show that boosted his profile, pumping iron and popping pills had been replaced by correspondence. “I receive at least fifty or sixty letters and phone-calls a day,” he told his father with the same pride he formerly felt after squatting 575lb, “and, if anything, this number is increasing!”
What was Sacks trying to satiate? His substance abuse, the workaholism that eventually displaced it, speaks of the addict’s need to fill or stuff a void, an effort to forestall the unbearable loneliness that might accompany a moment’s rest. And loneliness certainly runs through these pages. Sacks once felt that his very existence was only made tolerable by rejecting intimacy and becoming “impersonal or supra-personal”; relationships, he said, were a forbidden area for him.
Late in life, he cited internalised homophobia as the driving force behind this isolation, a heart-rending admission, given that he temporarily felt liberated from this oppressive “social matrix” during that short-lived 1965 love affair with Jenö. It wasn’t until 2008, after 30-odd years’ celibacy, that an epistolary meet-cute with the writer Bill Hayes precipitated a loving, intimate companionship, one that would last the remainder of Sacks’s life. It’s a touching if bittersweet moment that arrives towards the end of Letters, the coda to this portrait of a man who, half a century earlier, had travelled across the world hoping to meet a poet who might truly understand him.