Oliver Sacks: The P.T. Barnum of the Postmodern World?

The historic problem in representing disabled people's lives has always been the control of that representation. When others speak for the disabled, they often point the way to the freak show and the medical theater, two arenas of human objectification. The freak show, which flourished well into the twentieth century, depended on the spectacular mystification of disability; promoters exhibited disabled people as wondrous creatures of stupefying difference. Medical discourse has been fairly credited with killing off the freak show by rendering its fantastic displays in prosaic terms as medical anomalies. ¹ But in place of the freak show's alienating presentations, medicine has substituted a different kind of objectification, reducing disabled people to case studies of their "defects" and turning them into props in a theatrical display of pathology. Typically, contemporary narratives of disabled lives treat the freak show and the medical case study as Scylla and Charybdis--the author usually designs a course to avoid them, often seeking to repudiate one or both along the way. Within this conventionally straitened genre, Oliver Sacks is a one-man countertrend. Rather than setting a course between the freak show and the case study, he has combined aspects of both. And, as I will suggest, his still-evolving methodology has become increasingly collaborative within these parameters.

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Sacks's project becomes clearly visible in his second book, Awakenings, the account of his work in the late 1960s and early 1970s with a sanitarium population of people who were paralyzed by a strain of encephalitis during and after the 1918 influenza epidemic. ² When Sacks (who is a neurologist) gave his group of post-encephalitics L-DOPA, a dopamine replacement therapy which was an experimental drug, the patients "woke up" in dramatic fashion, startling doctors with their sudden vitality. ³ The result was a kind of joyful bedlam in the chronic ward. Patients who had been silently cohabiting for decades could suddenly speak to each other, and to their loved ones. Sacks says that everyone "was caught up with the emotion, the excitement, and with something akin to enchantment, even awe" (xxiv). I want to emphasize the collective nature of this experience. As Sacks puts it in a long footnote, "there were fifty 'awakenings'" at one time, leading to "a camaraderie" where "they discovered, they delighted in, each other as people. . . . There was communal health, all that summer . . . and an elation of shared hope" (65). The decline also happened in concert: "Every setback in a patient aroused fear in the others . . . fear and helplessness spread like a contagion through the ward" (65). In sum, "I did not have fifty, isolated, insulable patients; I had a community which was like a single living organism" (66).

Given this collectivity, how revealing is the way that Sacks organizes his material in his book. Following some prefatory remarks on the circumstances of the situation (the disease, the drug, and so forth) and the uniqueness of what is to follow, he presents twenty consecutive individual case studies of his most memorable patients, including observations of physical appearance and some of their more fantastic disease- and drug-aided behaviors. (An example: before L-DOPA, there was a patient who would have "counting crises," where she would have to count to a number like 95,000, or raise 15 to the seventh power, before she could sleep [131]; after L-DOPA, she was at one point able to speak five hundred words a minute without missing a syllable [136].) Clustered together in the middle of the book, these case studies represent, in Sacks's words, "the true and unassailable centre of Awakenings" (xxxiv).

A comparison of the layout of the book with the architecture of a typical freak show yields some striking structural similarities. The talker outside the tent would tout the show, promising thrills from the oddities inside, coaxing the customer through the entrance. Once inside, the...