| David W. Harrington
Alumni Relations and Development Researcher
The Arts Initiative at Columbia University
(with help from Kate Edgar)
December 12, 2008
Dr. Sacks and the Core Curriculum
Columbia University Artist may seem like a strange choice of academic title, particularly when the first person to hold this title is also a medical doctor and a professor of Neurology and Psychology. This arrangement invites us to investigate Dr. Oliver Sacks's role at Columbia a bit further: What is a University Artist, and what is the relationship between science and art? Below, I will argue that Oliver Sacks's pursuit of medicine and writing embodies the intellectual mission of the university and that Dr. Sacks's combination of art with science is both good medicine and good citizenship.
A scientist and an artist
[I sense] a certain doubleness in me: that I feel myself a naturalist and a physician both; and that I am equally interested in diseases and people; perhaps, too, that I am equally, if inadequately, a theorist and a dramatist, am equally drawn to the scientific and the romantic, and continually see both in the human condition . . .
-Oliver Sacks, The Man Who Mistook His Wife for a Hat [1]
Dr. Sacks's "clinical tales" illuminate the fact that medicine is both a science and an art, thereby bridging traditional gulfs between the two disciplines. Just as Anton Chekhov's work as a physician informed the "naturalism" of his plays and short stories, and just as William Carlos Williams led a dual life as doctor and poet, Dr. Sacks uses his experiences as a physician to reflect on universal human themes of courage and survival. Sacks relates scientific research and medical understanding to the individual and ponders how our brains shape, and are shaped by, our own biographies. He is equally at home quoting Milton or Mozart and discussing functional MRI research or stereoscopic illusions. This places Dr. Sacks in good standing at Columbia University, both in terms of the university's educational goals and in terms of Columbia's community of like minded scientists and artists.
Rather than viewing writing and medicine as separate disciplines, the emerging field of narrative medicine demonstrates how story-telling can improve the effectiveness of care. Dr. Rita Charon, director of The Program in Narrative Medicine at the College of Physicians and Surgeons, often writes about how her classes in English at Columbia (which turned into a PhD) helped to make her a better doctor. [2] Dr. Aaron Manson, a Columbia University Medical Center (CUMC) physician and writer, describes how "writing is like practicing medicine. Doctors often write to console, just as they console while doctoring." [3]
The multidisciplinary approach to medicine at CUMC reflects a university-wide initiative to go beyond disciplinary boundaries. We might compare Oliver Sacks’s approach to writing and medicine to the habits encouraged by Columbia University’s Core Curriculum, the heart of undergraduate education at Columbia College, the Fu Foundation School of Engineering and Applied Science, and the School of General Studies. The Core prepares students to ask questions and draw conclusions using tools from the liberal arts and sciences. The very language that Columbia uses to describe the Core might also describe Dr. Sacks’s approach to neurology:
Central to the intellectual mission of the Core is the goal of providing all Columbia students, regardless of their major or concentration, with wide-ranging perspectives on significant ideas and achievements in literature, philosophy, history, music, art, and science. [4]
In the methodology of both Columbia University and Oliver Sacks, then, the journey towards a rich understanding of the world requires travel across disciplines.
Compassionate prescriptions: Understanding and community
My aim is not to make a system or to see patients as systems, but to picture a world, a variety of worlds – the landscapes of being where these patients reside.
-Oliver Sacks, Awakenings [5]
Just as Oliver Sacks's writing allows him to travel across disciplines, it also helps readers venture into new territory. This is not a coincidental or insignificant parallel; rather the travel within Dr. Sacks's work has implications for patients and reader alike.
Unusual things happen to the subjects of Oliver Sacks's "clinical tales." A man who can remember nothing for more than a few seconds is nonetheless able to play long and complicated piano pieces. A man mistakes his wife for a hat. Patients who have been "asleep" for decades suddenly spring to consciousness.
To the average person, these situations may seem strange, incomprehensible, or pitiful.
To the doctor who thinks only of "ordinary" medicine, these may be nothing more than severe cases of strictly physiological phenomena. Both interpretations are understandable, but there is another way to approach these rare medical and emotional conditions. At the heart of this second approach lies a problem that we might describe as moral, political, humanistic, or medical. Because the illnesses that Dr. Sacks encounters are often uncommon conditions of body and mind, they also have the capacity to inflict isolation and suffering, both emotional and physical. How can a doctor, or an average citizen, reach a person who feels solitary and in pain? How can the patient reach out to her physician and others so as not to be so alone?
Writer and neurologist Oliver Sacks demonstrates how readers might view illness through the eyes of a cosmopolitan traveler. Dr. Sacks ventures into the worlds inhabited by patients with amnesia, Alzheimer’s, brain tumors, deafness, or Tourette's Syndrome. He uses illness and patients' experiences as lenses through which we can examine and learn how the brain works. He relates the experiences of these patients and their doctors so that we can fully understand both an illness and the individual who has it. This empathetic, multidisciplinary approach to medicine lends universal appeal to Sacks's clinical tales about often isolating illnesses. Dr. Sacks's work also demonstrate why other physicians, such as Manson and Charon, believe that good medicine and writing are so closely linked.
Clinical tales as journeys and Dr. Sacks as our tour guide
To restore the human subject at the centre . . . we must deepen a case history to a narrative or tale; only then do we have a ‘who’ as well as a ‘what’, a real person, a patient, in relation to disease . . .
-Oliver Sacks, The Man Who Mistook His Wife For a Hat [6]
In his review of An Anthropologist on Mars, School of the Arts professor Richard Locke notes that Dr. Sacks’s style "hums with emotional and intellectual energy." [7] Sacks immerses his readers in rich cultural, medical, and personal worlds. In one paragraph, Dr. Sacks may quote John Donne and A.R. Luria, and then refer to The Grateful Dead on the next page. These diversions are like hyperlinks—invitations into other works. Dr. Sacks’s own description of Awakenings (1973) explains the purpose of his form: "The general style of this book – with its alternation of narrative and reflection, its proliferation of images and metaphors, its remarks, repetitions, asides, and footnotes – is one which I have been impelled towards by the very nature of the subject-matter." [8] In other words, his quest to fully understand his patients requires him to make many side trips.
Similarly, Dr. Sacks sees writing and medicine as traveling companions. "I think writing and language are not just to articulate or communicate, but they are also to investigate. For me, writing and medicine, writing and science, are not separate: they entail each other." [9] In Awakenings, Hester Y can only begin to understand her 20-year Parkinsonian catatonia by writing down her thoughts in a journal. In An Anthropologist on Mars (1995), Dr. Sacks meets Temple Grandin, an autistic woman who helps the world understand her through autobiography. Dr. Sacks also uses writing to tell the story of his own experience as a patient; A Leg to Stand On (1984) recounts the aftermath of an injury he sustained on a Norwegian mountainside. In Oaxaca Journal, Dr. Sacks expands upon his journal of a botanical vacation to investigate the culture of ancient Mesoamerica.
Returning to the Core
In addition to fostering ties among students and faculty, these courses create a community of intellectual discourse that spills over beyond the classroom and into dormitories, dining halls, and the many cafés that surround the campus.
-"The Core Curriculum" [10]
Dr. Sacks's sense of wonder and intrepidness goes hand in hand with the emotional and intellectual energy of his style. As Richard Locke points out, "Nothing human is alien" to Dr. Sacks. This helps his writing become, at the same time, necessary medicine, a form of humanism, and a fascinating examination of neurological, psychological, and geographical places to which we might otherwise never venture. It also returns us to the intellectual mission behind the Core Curriculum, the goal of which is not only to produce good scholars but good citizens.
Further Travel: More of Dr. Sacks's Clinical Tales
References
[1] Oliver Sacks, The Man Who Mistook His Wife For a Hat (New York: Touchstone, 1985), viii. Read it.
[2] Rita Charon, "Narrative Medicine," LitSite Alaska, http://litsite.alaska.edu/healing/medicine.html
[3] Aaron Manson, "Why Do Doctors Write?" In Vivo, Columbia University Medical Center, January 26, 2004. Read it.
[4] Columbia College, "Core Curriculum," http://www.college.columbia.edu/core/.
[5] Oliver Sacks, Awakenings (New York: Harper, 1990), xviii. Read it.
[6] Oliver Sacks, The Man Who Mistook His Wife For a Hat, vii. Read it.
[7] Richard Locke, "Richard Locke reviews Oliver Sacks’s ‘An Anthropologist on Mars: Seven Paradoxical Tales,’" Wall Street Journal, March 2, 1995, A12.
[8] Oliver Sacks, Awakenings, xviii. Read it.
[9] Oliver Sacks, "Narrative and Science," in a recorded speech delivered at Rockefeller University, March 18, 2002, http://www.rockefeller.edu/lectures/sacks031802.html.
[10] Columbia College, "Core Curriculum," http://www.college.columbia.edu/core/.
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