Uncle Tungsten

by Oliver Sacks

  My parents’ medical books nourished these fears, fed an incipient disposition to hypochondria. Around the age of twelve I developed a mysterious, though hardly life-threatening, skin condition, which produced an exudation of serum behind my elbows and knees, stained my clothing, and made me avoid ever being seen undressed. Was it my fate, I wondered fearfully, to get one of these skin disorders or monstrous tumors I had read about – or was progeria the unspeakable fate that was reserved for me?

  I was fond of the Morrison table, a huge table of iron that was lodged in the breakfast room, and which was strong enough, supposedly, to bear the whole weight of the house if we were bombed. There had been many accounts of such tables saving the lives of people who would otherwise have been crushed or suffocated beneath the debris of their own houses. The whole family would take cover under the table during air raids, and the notion of this protection, this shelter, took on an almost human character for me. The table would protect us, look out for us, care for us.

  It was very cozy, I felt, almost a little cottage within the house, and when I came back from St. Lawrence College, at the age of ten, I would sometimes crawl under it and sit or lie there, quietly, even when there was not an air raid.

  My parents recognized that I was in a fragile state at this time, and they offered no comments when I retreated and crawled under the table. But one evening, when I emerged from beneath it, they were horrified to see a bald circle on my scalp – ringworm was their instant, medical diagnosis. My mother scrutinized me more closely and murmured with my father. They had never heard of ringworm appearing with such suddenness. I admitted nothing, tried to look innocent, and concealed the razor, Marcus’s razor, which I had taken with me under the table. The next day, they took me to a skin specialist, a Dr. Muende. Dr. Muende gave me a piercing glance – I had no doubt that he saw straight through me – took a specimen of hair from the bare spot, and put it under his microscope to examine. After a second, he said, ‘Dermatitis artefacta ‘ meaning that the hair loss was self-inflicted, and when he said this, I blushed a deep crimson. There was no discussion afterwards as to why I had shaved my head, or lied.

  My mother was an intensely shy woman who could hardly bear social occasions and would retreat into silence, or her own thoughts, when forced into them. But there was another side to her character, and she could become expansive, exuberant, a ham, a performer, when she was at ease, with her students. Many years later, when I took my first book to an editor at Faber’s, she said, ‘You know, we’ve met before.’

  ‘I don’t think I remember,’ I said, embarrassed. ‘I can never recognize faces.’

  ‘You wouldn’t,’ she rejoined. ‘It was many years ago, when I was a student of your mother’s. She was lecturing on breast-feeding that day, and after a few minutes she suddenly broke off, saying, ‘There’s nothing too difficult or embarrassing about breastfeeding.’ She bent down and retrieved a small baby which had been sleeping, concealed behind her desk, and, unwrapping the infant, breastfed it before the class. It was in September 1933, and you were the infant.’

  I, too, have my mother’s shyness, her dread of social occasions, as well as her flamboyance, her exuberance in front of an audience, in equal measure.

  There was another level, a deeper level, in her, a realm of total absorption in her work. Her concentration when she was operating was absolute (though she might break the almost religious silence at times by telling a joke or giving a recipe to one of her assistants). She had an intense feeling for structure, the way things were put together – whether they were human bodies, or plants, or scientific instruments or machines. She still had the microscope, an old Zeiss, she had had as a student, and kept it polished and oiled and in perfect shape. She still enjoyed sectioning specimens, hardening them, fixing them, staining them with different dyes – the whole intricate panoply of techniques used to make sectioned tissues stable and richly visible. She introduced me to some of the wonders of histology with these slides, and I came to recognize – in the brilliant stains of hemotoxylin and eosin, or blackly shadowed with osmium – a variety of cells both healthy and malignant. I could appreciate the abstract beauty of these slides without worrying too much about the disease or surgery that had brought them into being. I loved, too, the odorous gums and liquids used to make them; the smells of clove oil, cedarwood oil, Canada balsam, xylene are still associated, in my mind, with the memory of my mother, intently bending over her microscope, totally absorbed.

  Though both my parents were highly sensitive to the sufferings of their patients – more so, I sometimes thought, than to those of their children – their orientations, their perspectives, were fundamentally different. My father’s quiet hours were all spent with books, in the library, surrounded by biblical commentaries or occasionally his favorite First World War poets. Human beings, human behavior, human myths and societies, human language and religions occupied his entire attention – he had little interest in the nonhuman, in ‘nature,’ as my mother had. I think my father was drawn to medicine because its practice was central in human society, and that he saw himself in an essentially social and ritual role. I think my mother, though, was drawn to medicine because for her it was part of natural history and biology. She could not look at human anatomy or physiology without thinking of parallels and precursors in other primates, other vertebrates. This did not compromise her concern and feeling for the individual – but placed it, always, in a wider context, that of biology and science in general.

  Her love of structure extended in all directions. Our old grandfather clock, with its intricate dials and inner machinery, was very delicate, needing constant care. My mother undertook this entirely herself, becoming a sort of horologist in the process. Similarly with other things in the house, even the plumbing. There was nothing she liked more than mending a leaky faucet or a toilet, and the services of outside plumbers were usually not needed.

  But her best hours, her happiest hours, were spent in the garden, and here her sense of structure and function, her esthetic feeling, and her tenderness came together – plants, after all, were living creatures, much more wonderful, but also more needy, than clocks or cisterns. When, years later, I came across the phrase ‘a feeling for the organism’ – often used by the geneticist Barbara McClintock – I realized that this defined my mother exactly, and that this feeling for the organism underlay everything from her green thumb in the garden to the delicacy and success of her operations.

  My mother loved the garden, the large plane trees that edged Exeter Road, the lilacs that filled it with their scent in May, and the climbing roses that trellised its brick walls. She gardened whenever she could, and was especially attached to the fruit trees she had planted – a quince tree, a pear tree, two crab apples, and a walnut. She was particularly fond of ferns as well, and the ‘flower’ beds were almost entirely filled with them.

  The conservatory, at the far end of the drawing room, was one of my favorite places, the place where, before the war, my mother had kept her most tender plants. It somehow escaped being shattered during the war, and when my own botanical interests blossomed, I shared it with her. I have tender memories of a tree fern, a woolly Cibotium, I tried to grow there in 1946, and a cycad, a Zamia, with stiff cardboard leaves.

  Once, when my nephew Jonathan was a few months old, I picked up a packet of X-rays marked ‘J. Sacks’ that had been left in the lounge. I started to leaf through them curiously, then perplexedly, then with horror – for Jonathan was a nice-looking little baby, and no one would have guessed, without the X-rays, that he was hideously deformed. His pelvis, his little legs – they scarcely looked human.

  I went to my mother with the X-rays, shaking my head. ‘Poor Jonathan…’ I started.

  My mother looked puzzled. ‘Jonathan?’ she said. ‘Jonathan is fine.’

  ‘But the X-rays,’ I said, ‘I’ve been looking at his X-rays.’

  My mother looked blank, then burst into a roar of laughter, and laughed until the
tears ran down her face. ‘J’ did not stand for Jonathan, she finally said, but for another member of the household, Jezebel. Jezebel, our new boxer, had had some blood in her urine, and my mother had taken her to hospital to have a kidney X-ray. What I had taken for grotesquely deformed human anatomy was, in fact, perfectly normal canine anatomy. How could I have made such an absurd mistake? The least knowledge, the least common sense, would have made it all clear to me – my mother, a professor of anatomy, shook her head in disbelief.

  My mother’s practice had moved, sometime in the 1930s, from general surgery to gynecology and obstetrics. There was nothing she loved more than a challenging delivery – an arm presentation, a breech – brought off successfully. But she would occasionally bring back malformed fetuses to the house – anencephalic ones with protruding eyes at the top of their brainless, flattened heads, or spina bifida ones in which the whole spinal cord and brainstem were exposed. Some of these had been still-born, others she and the matron had quietly drowned at birth (‘like a kitten,’ she once said), feeling that if they lived, no conscious or mental life would ever be possible for them. Eager that I should learn about anatomy and medicine, she dissected several of these for me, and then insisted, though I was only eleven, that I dissect them myself. She never perceived, I think, how distressed I became, and probably imagined that I was as enthusiastic here as she was. Though I had taken to dissecting naturally, by myself, with earthworms and frogs and with my octopus, the dissection of these human fetuses filled me with revulsion. My mother often told me how she had worried about the growth of my own skull as an infant, fearing that the fontanelles had closed too early, and that I would be, in consequence, a microcephalic idiot. Thus I saw in these fetuses what (in imagination) I, too, could have been, and this made it more difficult to distance myself, and heightened my horror.

  Though it was understood, almost from my birth, that I would be a doctor (and specifically, my mother hoped, a surgeon), these precocious experiences turned me against medicine, made me want to escape and turn to plants, which had no feelings, to crystals and minerals and elements, above all, for they existed in a deathless realm of their own, where sickness and suffering, pathology, held no sway.

  When I was fourteen, my mother arranged with a colleague, a professor of anatomy at the Royal Free Hospital, that I should be inducted into human anatomy, and Professor G., agreeable, took me to the dissecting room. There, on long trestles, lay the bodies, wrapped in yellow oilskin (to keep the exposed tissues from drying when they were not being dissected). This was the first time I had ever seen a corpse, and the bodies looked oddly shrunken and small to me. There was a horrible smell of mortified tissue and preservative in the air, and I came near to fainting as I went in – there were spots before my eyes and a sudden surge of nausea. Professor G. said she had selected a body for me, the body of a fourteen-year-old girl. Some of the girl had been dissected already, but there was a nice, untouched leg I could start on. I had a desire to ask who the girl was, what she had died of, what had brought her to such a pass – but Professor G. preferred no information, and in a way I was glad, for I dreaded to know. I had to think of this as a cadaver, a nameless thing of nerves and muscles, tissues and organs, to be dissected as one would dissect a worm or a frog, to learn how the organic machine was put together. There was a manual of anatomy, Cunningham’s Manual, at the head of the table; this was the copy the medical students used when they were dissecting, and its pages were yellowed and greasy with human fat.

  My mother had bought me a Cunningham the week before, so that I had some knowledge, but this in no way prepared me for the actual experience, the emotional experience, of dissecting my first body. Professor G. started me off with a broad initial incision down the thigh, parting the fat and exposing the fascia beneath. She gave me various tips, then she thrust the scalpel into my hand – she would be back in half an hour, she said, to see how I was getting on.

  It took me a month to dissect the leg; the most difficult was the foot, with its little muscles and stringy tendons, and the knee joint, with all its complexity. Occasionally I could feel how beautifully everything was put together, could enjoy an intellectual and esthetic pleasure such as my mother got from surgery and anatomy. Her own professor, in her medical student days, had been the famous comparative anatomist Frederic Wood-Jones. She loved the books he had written – Arboreal Man, The Hand, and The Foot – and cherished the copies he had inscribed for her. She was amazed when I said I could not ‘understand’ the foot. ‘But it is like an arch,’ she said, and started drawing feet – drawings an engineer might have done, from every angle, to show how the foot combined stability with flexibility, how beautifully designed or evolved it was for walking (though bearing obvious residues of its original, prehensile function too).

  I lacked my mother’s powers of visualization, her strong mechanical and engineering sense, but I loved it when she talked of the foot and drew, in rapid succession, the feet of lizards and birds, horses’ hooves, lions’ paws, and a series of primate feet. But this delight in understanding and appreciating anatomy was lost, for the most part, in the horror of the dissection, and the feeling of the dissecting room spread to life outside – I did not know if I would ever be able to love the warm, quick bodies of the living after facing, smelling, cutting the formalin-reeking corpse of a girl my own age.

  CHAPTER TWENTY

  Penetrating Rays

  It was in Abe’s attic that I was introduced to cathode rays. He had a highly efficient vacuum pump, and an induction coil – a two-foot-long cylinder wound with miles and miles of densely coiled copper wire and set on a mahogany base. There were two large moveable brass electrodes above the coil, and when the coil was switched on, there would leap between them a formidable spark, a miniature lightning bolt, something out of Dr. Frankenstein’s lab. Uncle showed me how he could separate the electrodes until they were too far apart to spark and then connect them to a yard-long vacuum tube. As he reduced the pressure in the electrified tube, a series of extraordinary phenomena appeared inside it: first a flickering light with red streamers like a miniature Aurora Borealis, then a brilliant column of light filling the whole tube. As the pressure was lowered still further, the column broke into discs of light separated by dark spaces. Finally, at a ten-thousandth of an atmosphere, everything became dark again inside the tube, but the end of the tube itself started to glow with a brilliant fluorescence. The tube was now filled, Uncle said, with cathode rays, little particles shot off the cathode with a tenth the speed of light, and so energetic that if one converged them with a saucer-shaped cathode they could heat a piece of platinum foil to red heat. I was a little afraid of these cathode rays (as I had been, as a child, of the ultraviolet rays in the surgery), for they were both potent and invisible, and I wondered if they could leak out of the tube and dart at us, unseen, in the darkened attic.

  Cathode rays, Uncle Abe assured me, could travel only two or three inches in ordinary air – but there was another sort of ray, far more penetrating, which Wilhelm Roentgen had discovered in 1895 while experimenting with just such a cathode-ray tube. Roentgen had covered the tube with a cylinder of black cardboard to prevent any leakage of cathode rays, and yet he was astounded to observe that a screen painted with a fluorescent substance lit up brilliantly with each discharge of the tube, even though it was halfway across the room.

  Roentgen immediately decided to drop his other research projects in order to investigate this totally unexpected and almost incredible phenomenon, repeating the experiment over and over again to convince himself that the effect was authentic. (He told his wife that if he spoke of it without the most convincing evidence, people would say, ‘Roentgen has gone mad.’) For the next six weeks he investigated the properties of these extraordinarily penetrating new rays and found that, unlike visible light, they could not, apparently, be refracted or diffracted. He tested their ability to pass through all sorts of solids and found they could pass to some degree through most c
ommon materials and still activate a fluorescent screen. When Roentgen placed his own hand in front of the fluorescing screen, he was astonished to see a ghostly silhouette of its bones. A set of metal weights, similarly, became visible through their wooden box – wood and flesh were more transparent to the rays than metal or bone. The rays also affected photographic plates, he found, so that in his first paper he was able to publish photographs taken by the X-rays, as he called them – including a radiograph of his wife’s hand, her wedding ring encircling a skeletal finger.

  On January 1, 1896, Roentgen published his findings and first radiographs in a small academic journal. Within days the major newspapers of the world picked up the story. The sensational impact of his discovery horrified the shy Roentgen, and after his initial paper and a verbal presentation the same month, he never discussed X-rays again, but returned to working quietly on the varied scientific interests which had engrossed him in the years before 1896. (Even when he was awarded the first Nobel Prize in physics in 1901 for his discovery of X-rays, he declined to give a Nobel speech.)

  But the usefulness of this new technology was readily apparent, and X-ray facilities were rapidly set up around the world for medical use – to detect fractures, find foreign bodies, gallstones, etc. By the end of 1896, more than a thousand scientific articles on X-rays had appeared. The response to Roentgen’s rays, indeed, was not only medical and scientific, but seized the public imagination in various ways. One could buy, for a dollar or two, an X-ray photograph of a nine-week-old infant ‘showing with beautiful detail the bones of the skeleton, the stage of ossification, the location of the liver, stomach, heart, etc.’