MY FIRST direct contact with the neurologist and author Oliver Sacks was in 2008, when I invited him to contribute an essay to a series about migraines in the Opinion section at The New York Times, where I was a web editor. I was doubtful he’d accept the offer. This was back before the internet had completely eaten newspapers. Web, though it is hard to imagine now, was still kind of fringe. Neither my job nor the clunky Word Press platform we used to edit and publish our work was very prestigious.
I developed the series — called simply “Migraine” — on the suggestion of my boss, the Op-ed editor David Shipley, who also cleverly subtitled it “Perspectives on a Headache.” I invited notable migraine sufferers like Siri Hustvedt and Jeff Tweedy to write, but the biggest catch of all was Oliver Sacks.
By then, nearly forty years into his career, Oliver was well-established as the world’s most famous and beloved literary doctor, with a level of notoriety and book sales figures few authors could match. But “Migraine,” his first book, published in 1970, when he was still a largely unrecognized neurologist, was not often discussed (W.H. Auden, a friend and mentor to the young Oliver, gave it a mixed review in the New York Review of Books in 1971). Over time it was eclipsed by bestsellers like Awakenings and The Man Who Mistook His Wife for a Hat. Perhaps because of the chance to revisit one of his foundational subjects appealed to him, Oliver agreed. Within days, he delivered a fascinating hybrid personal and scientific piece about “visual migraines” — essentially hallucinations — experienced by migraine sufferers, and the artistic work they produced in response.
The essay, titled “Patterns,” was widely read and warmly received, and Oliver followed the essay by providing responses to reader comments on it, which we also published. As a fledgling editor still uncertain about my qualifications, I was relieved to have avoided any humiliating mistakes. And I was grateful to Oliver for saying yes and trusting me with his work.
I SAW Oliver intermittently at events over the next few years, and on one occasion, in 2013, I spent an evening with him in his Horatio Street apartment with his partner Bill Hayes, whose work I had also edited, where Oliver spoke openly to me about his history with writer’s block, in hopes of helping me to through my own writing drought. This visit was a favor Oliver kindly carried out at Bill’s request. I was grateful for that, too.
My next chance to work with Oliver arose less than two years later, in February 2015, when I received the following email from Bill:
Hey Peter: do u have time for a quick call? Oliver has written an amazing piece which he’d like to send you for the NYT, but he asked me to talk with you about it first. -bh
I was excited to hear this, at least until Bill called and told me about the essay and how it came to be. Oliver had metastatic cancer, he said. There were surgeries planned to slow the cancer’s advance, but it was not curable. Oliver’s doctors had estimated that he had roughly six months to live.
I recall that Bill’s voice was strained, almost a whisper — perhaps because he was making the call from a bathroom stall off a waiting room at Sloan Kettering, while Oliver and his longtime assistant and book editor Kate Edgar remained inside. At a few silent points in the conversation, I mumbled my regrets.
Doctors had delivered the cancer diagnosis, Bill told me, in January, not long after Oliver had submitted the completed manuscript of his autobiography On the Move, the book that he’d expected to be the summation and final account of his remarkable life. But this last, devastating chapter would be absent from the book: On the Move had already gone to press. Whatever writing Oliver could produce between this point and the time of his death would stand as the book’s coda.
Bill told me that Oliver had been holding off on publishing the essay because most of those close to him were still unaware of his diagnosis, and he didn’t want them to learn of it in the press. But now, waiting to be admitted for the first embolism surgery to his liver, the site to which his cancer had aggressively spread, he abruptly changed his mind. Oliver knew that he would be put under general anesthesia and subject to a major invasive surgery, a prospect that frightened him, and he did not want to die leaving “My Own Life” unpublished. As Bill wrote to me in a note soon after: “He suddenly turned to Kate and me and said something like, ‘I am ready — let’s do it now.’ We were taken aback! Now? I immediately went into a bathroom off the waiting room and called you.”
A few hours later, as Oliver was undergoing his surgery, Kate sent me Oliver’s essay — a short, philosophical reflection that he had written to announce his illness and prognosis to the public, assessing the meaning and value of his 81 years on earth, and stating how he intended to live out his last days. He had taken the title from an autobiographical essay reportedly written in a single day in 1776 by the philosopher David Hume when his own death was imminent. Hume’s document is notable for its persistent and dignified good cheer under the circumstances, and the absence of any deathbed conversion to a God he had painstakingly argued against in his philosophical work.
In Oliver’s “My Own Life,” a concise 900-word piece that would require very little editing, the doctor who had abruptly become a patient began: “A month ago, I felt that I was in good health, even robust health. At 81, I still swim a mile a day. But my luck has run out — a few weeks ago I learned that I have multiple metastases in the liver.” And then, “I am now face to face with dying.”
Oliver vowed to live his remaining days to the fullest. “It is up to me now to choose how to live out the months that remain to me,” he wrote. “I have to live in the richest, deepest, most productive way I can.” He would later keep that vow — traveling, spending time with friends and loved ones, and writing essays and letters at a furious pace even as the illness gradually took its toll. He also expressed a deep sense of gratitude for the chance he’d been given to be “a sentient being, a thinking animal, on this beautiful planet.”
After a day and night of somewhat frantic editing and back and forth with Kate and Bill, the essay was published online on Feb. 19, and in print the next day. It attracted — according to the crude metrics that were available to us at the time — some three million readers in its first week, and then countless more afterward. It also drew an unusual outpouring from those readers, expressing their affection for him openly and often with great emotion — evidence of the bond he had formed with the public through his life and work. As a small favor and gesture of thanks for trusting me and The Times with this piece, I later gathered the some 800 comments and delivered them to him by email. Oliver later admitted that reading thee messages as he recovered from his surgery had brought him to tears.
This was the beginning of Oliver’s journey through the public accounting of his last days. Four other essays came my way in the next six months, three of which were accepted and published in The Times. “Mishearings,” a classic Sacksian investigation of hearing loss, was published in June. Another, Oliver’s meditative love letter to the natural world entitled “My Periodic Table,” arrived in July. Then, the essay that would turn out to be his very last, “Sabbath.”
I have often wondered just how to describe this time. What was it like for Oliver? How did he experience it? Is there a name for the period between a person’s fatal diagnosis and their death? There should be. This time by its nature cannot possess the qualities that constitute “ordinary” time — that hopefully long stretch of days during which we fend off the knowledge of our deaths and go about our business. The time lived in the shadow of death must be special, distinct, crushingly weighted by grief, anxiety and fear, even terror, even for the most clear-eyed and stoic among us, but also lit from within by its finitude, by the end of consciousness rushing in from the distance.
For me, that intensity of that time culminated when “Sabbath” arrived in my inbox in early August with a warm, but sobering note from Oliver. I had, with some trepidation, rejected a previous vignette of Oliver’s the week before because it seemed to lack the end-of-life insight and gravity that had made “My Own Life” and “My Periodic Table” so special. (That rejected piece, “Filter Fish,” was published soon after he died, in The New Yorker.)
“I now enclose a serious and substantial piece — ‘Sabbath’— for your consideration,” he wrote. For the benefit of the space-conscious newspaper editor he knew he was addressing, he added: “I am aware that it is somewhat on the long side, but I cannot see my way to cutting it anymore without damaging it.”
And then: “I am very weak now, and ‘Sabbath’ will probably be the last thing I write — my ‘last words.’ ”
In his lifetime, Oliver was best known for his collections of scientific narratives. But “Sabbath” was different — a deeply learned personal and philosophical reflection of a man nearing his own end. Written during the astonishing stretch of productivity that lasted throughout his illness, it traced a path from his Orthodox Jewish upbringing in 1940s and 50s London, which he fled during his awakening as a young gay man, to his life in America and then back again, welcomed at last in the warmth of his family and its ritual Sabbath, with Bill at his side.
He had reached that place of equanimity, as he wrote in the closing sentence of the piece, “when one can feel that one’s work is done, and one may, in good conscience, rest.”
On the surface “Sabbath” was about one man’s experience with family, religion, sexuality, and identity. But, like most great works of reflection, it was about universal themes, too: tolerance, acceptance, and the healing power of belonging.
In the end, the doctor’s prognosis was right. “Sabbath” was published in The Times on Aug. 16. He died two weeks later, at home in his apartment in New York City, on Aug. 30.
AT THE TIME of his death, Oliver was more than a successful author; he was arguably the world’s most famous doctor. He wrote more than a dozen books and revived the art of both medical narrative (the journalism and storytelling practiced by doctor-writers like Atul Gawande and Siddhartha Mukherjee and now countless others) and of narrative medicine (actual health care shaped by the subjective stories of patients and practitioners). By way of his powerful, curious mind, his detective’s eye, his ocean-deep knowledge of literature, philosophy and science — not to mention his quirky British elocution and charm — he became a popular figurehead, seen by many as the embodiment of science.
Those last months of Oliver’s life, his public declaration of his illness, and imminent end, which he wrote about with a Humean tone of stoic dignity, in the spirit of scientific and philosophical curiosity, and with a touching vulnerability and openness, was for many what his friend Lawrence Weschler called “a master class in how to die.”
Oliver was the rare author who was truly beloved by his readers. Many admitted being inspired by him to pursue medical careers. Others saw themselves in his case studies — those who were or knew or loved someone who was “different,” disabled, ill or somehow out of the mainstream definition of “normal.” While Oliver’s work made some readers uncomfortable, for its packaging of the lives and conditions of his patients for commercial literary consumption, many felt that it repaired some of the damage done by a world that had sidelined or ignored them because of their illnesses, or had denied them their humanity. It made many of them feel acknowledged, seen and heard.
I believe that when his readers took to mourning him, they were ultimately mourning not just the man, but what Oliver came to represent for them: the cause of science itself. Oliver had become, perhaps accidentally, a torch bearer for the importance of compassion and tolerance in medicine, for the open recognition of the obligation to humanity inherent in the pursuit of science. Everything, in other words, that we are so critically at risk of losing in our society today.
LAST MONTH I came upon a trailer for the second season of the NBC TV series Brilliant Minds. The show is inspired by and based on several case histories included in Oliver’s books The Man Who Mistook His Wife for a Hat and An Anthropologist on Mars. The show was produced with the blessing of the Oliver Sacks Foundation.
Brilliant Minds is the latest expression of what I’d call Oliver’s afterlife — not a supernatural afterlife, but something more quotidian — what plays out here on earth after we die, the ongoing effects of our works and deeds on those who survive us.
Oliver’s public afterlife has been robust in the decade since his death: Three posthumous volumes of essays were quickly published (the first, the bestseller Gratitude, collected three of the essays I’d shepherded to publication at The Times); then came the 2019 documentary His Own Life, directed by Ric Burns; the podcast, Radiant Minds, based on his life and work; the publication of an extensive volume of his letters edited by Kate Edgar; and the news last year of the acquisition of his archives by the New York Public Library, insuring his work will be studied for many years to come.
All this has made the man once considered “the poet laureate of medicine” seem very much still among us.
In Brilliant Minds, the actor Zachary Quinto plays a TV-ready, liberally updated fictionalized version of the real Oliver, whose complexities, brilliance, charm and contradictions are blended and sweetened into a palatable ganache of a character. Those complexities and contradictions include the real Oliver’s struggles with prosopagnosia (known more commonly as “face blindness”), his years of failure to find acceptance in the mainstream medical community and the anguish caused by being forced to live most of his life as a closeted gay man.
The reconstituted fictional Dr. Sacks is an unconventional rule-breaker, an openly gay man who is also a young, handsome “tortured genius” entirely devoted to his patients. He is not too imaginatively named Dr. Oliver Wolfe (Wolf was Sacks’s middle name). The fictional doctor, much like the real one, is a motorcycle-riding renegade, a compassionate healer working in an institutional medical environment skeptical of his quirky and quasi-shamanistic approach to his patients but who, unlike his OG doctor inspiration, is living in a larger, more welcoming 21st-century America that doesn’t bat an eye at his sexual orientation.
The fictional doctor’s status as an accepted gay man is a well-meaning nod to the real doctor’s full personhood, but there is an inescapable dissonance caused by the differences in the two lives.
THESE DAYS I often recall another essay Oliver wrote during his last months, a brief one called “Life Continues,” published posthumously in the collection Everything in Its Place. In it, he wrote that “one may take comfort in the feeling that life will go on — if not for oneself then for one’s children, or for what one has created.”
But he then anxiously imagines the future of the world he is about to leave behind: “[I]t may not be enough to create, to contribute, to have influenced others, if one feels, as I do now, that the very culture in which one was nourished and to which one had given one’s best in return is itself threatened.”
Here he confesses alarm at the state of the planet on which he had been a “sentient being” existentially threatened by the rampant human destruction of the natural world and its ecosystems. He was troubled, too, by the quieter and more insidious conquest of the digital life over actual life, by the mass absorption of human attention and energy into computer screens and phones that thwart human contact and give us little but convenience in return. How, he wondered, will the great challenges faced by humankind be countered if the mental energy of billions of people is being directed into devices no bigger than their own hands, controlled by corporations who have neither their best interest, nor the best interest of the planet and all its inhabitants, at heart.
It is this next passage from “Life Continues,” though — written the year before the first election of a president who would return in 2025 to wage an open, seemingly nihilistic war on science as we knew it — that haunts me:
I dare to hope that, despite everything, human life and its richness of cultures will survive, even on a ravaged earth. While some see art as a bulwark of our culture, our collective memory, I see science, with its depth of thought, its palpable achievements and potentials, as equally important; and science, good science, is flourishing as never before, though it moves cautiously and slowly, its insights checked by continual self- testing and experiment.
Though I revere good writing and art and music, it seems to me that only science, aided by human decency, common sense, farsightedness, and concern for the unfortunate and the poor, offers the world any hope in its present morass.
I don’t believe that even someone with Oliver’s capacious imagination could have envisioned the kind of threat that science would be under a decade later, especially in the United States, the country that made his own life and career in science possible. I can only guess at the anguish it would have caused him, or what he would do in response. And although I would have never wished that anguish upon him, I do wish he was still here so we could find out now what he would say or do. In our utter confusion and uncertainty about the future, especially the future of science, we would certainly listen.
FOR ALL THE public iterations of Oliver’s afterlife, I find my own experience of his to be particular and private. I can’t claim to have known him well but given the intense experience of working with him on some of his final and most profound reflections till the very end — the editing unto death, I sometimes call it — I have often returned to read, study and mediate on the man and his work. And sometimes I’ve found it has affected me without me even knowing it.
Less than a year after he died, I developed a Times Opinion series called Disability, entirely devoted to the first-person accounts of disabled people. The idea for the series seemed to strike me like a beam of sunlight one day on a basketball court on the Lower East Side. The series ran for more than two years, resonated widely in the disability rights and literary communities, and resulted in a book of essays, “About Us.” I was sometimes asked how I came up with the idea. It was well into the first year that I finally realized the project’s source. The beam of sunlight was Oliver.
I find, though, that from day to day Oliver’s afterlife is with me in more quotidian ways, in the daily pleasures and activities that enriched his life and its meaning, and that overlap with my own.
I think of Oliver the dedicated swimmer every time I lower myself into a lap pool with a head swarming with thoughts I need to smooth out in an hour of slow, rhythmic, practically weightless movement through the water.
I think of Oliver the champion of ferns and gardens when I turn a Manhattan corner and duck into one of those green urban oases to take in the calming greens and leafy air on too busy days for my health and sanity.
I think of Oliver the library lover whenever I walk past the stone lions on 5th Avenue into the grand temple New York Public Library’s main reading room, where I experience the hush of readers and would-be scholars absorbed, concentrating, and learning in that enormous space.
I think of Oliver the champion weightlifter (the young man who dead lifted more than 600 pounds!) when I try to eke out 10 or 20 push-ups in the morning, or when I turn the other way at the gym any time I get near a barbell.
But I think of him most of all when I think and seek to express myself — as I am doing now — to find coherence in the world and my experience of it, as I try to each year better understand that world and the person that I am always becoming. In all this, I strive to hang on to the “human decency, common sense, farsightedness, and concern for the unfortunate and the poor” — in a word, my humanity — that he saw as essential, instead of surrendering to anger or despair, even as ignorance, violence, and venality seem to be winning.
This was a task that Oliver never abandoned, even as he composed his very last words. And, it’s one that I never will either.
For that, I’ll always be grateful.
