On the Move: A Life

by Oliver Sacks

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  Jim was very much part of my life in Southern California—we would see each other two or three times a week—and I missed him acutely when I moved to New York. After 1970, his interest in computer games (including war games) spread to the use of computer animation in science-fiction films and cartoons, which kept him in Los Angeles.

  When Jim visited me in New York in 1972, he looked well and happy; he was looking forward to the future, though it was not clear whether this would be in California or South America (he had spent a couple of years in Paraguay, where he greatly enjoyed life and had bought a ranch).

  He said that he had not taken a drink in two years, and this especially pleased me because he had had a dangerous habit of going on sudden drinking binges, and the last one I knew about had given him pancreatitis.

  He was on his way to Salt Lake City to spend time with his family. Three days later, I got a phone call from Kathy telling me that Jim was dead: he had gone on another drinking binge and again developed pancreatitis, but this time it was followed by necrosis of the pancreas and generalized peritonitis. He was only thirty-five.6

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  One day in 1963, I went bodysurfing off Venice Beach; it was rather rough water and no one else was in, but I, at the height of my strength (and grandiosity), was sure I could handle it. I was thrown around a bit—this was fun—but then a huge wave came towering far above my head. When I attempted to dive under it, I got flung on my back and tumbled over and over helplessly. I did not realize how far the wave had carried me until I saw it was about to crash me on the shore. Such impacts are the commonest cause of broken necks on the Pacific coast; I had just time to stick out my right arm. The impact tore my arm back and dislocated my shoulder, but it saved my neck. With one arm disabled, I could not crawl out of the surf quickly enough to get away from the next huge breaker, which was following close on the first. But at the last second, strong arms seized me and pulled me to safety. It was Chet Yorton, a very strong young bodybuilder. Once I was safely on the beach, in excruciating pain with the head of my humerus sticking out in the wrong place, Chet and some of his weight-lifting buddies grabbed me—two round the waist, two pulling the arm—until the shoulder went back into place with a squelch. Chet went on to win the Mr. Universe competition, and he was still superbly muscled at the age of seventy; I would not be here had he not pulled me out of the water in 1963.7 The moment the joint was back in place, the shoulder pain vanished, and I became conscious of other pains in my arms and chest. I got on my motorbike and rode to the emergency room at UCLA, where they found I had a broken arm and several broken ribs.

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  There were occasional weekends when I was on call at UCLA and others when I supplemented my meager income by moonlighting at the Doctors Hospital in Beverly Hills. On one occasion there, I met Mae West, who was in for some small operation. (I did not recognize her face, for I am face-blind, but I recognized her voice—how could one not?) We chatted a good deal. When I came to say good-bye to her, she invited me to visit her in her mansion in Malibu; she liked to have young musclemen around her. I regret that I never took up her invitation.

  Once my own strength came in handy on the neurological wards. We were testing visual fields in a patient unlucky enough to have developed a coccidiomyces meningitis and some hydrocephalus. While we were testing him, his eyes suddenly rolled up in his head and he started to collapse. He was “coning”; this is the rather mild term used for a terrifying event in which, with excessive pressure in the head, the cerebellar tonsils and brain stem get pushed through the foramen magnum at the base of the skull. Coning can be fatal within seconds, and with the speed of reflex I grabbed our patient and held him upside down; his cerebellar tonsils and brain stem went back into the skull, and I felt I had snatched him from the very jaws of death.

  Another patient on the ward, blind and paralyzed, was dying from a rare condition called neuromyelitis optica, or Devic’s disease. When she heard that I had a motorbike and lived in Topanga Canyon, she expressed a special last wish: she wanted to come for a ride with me on my motorbike, up and down the loops of Topanga Canyon Road. I came to the hospital one Sunday with three weight-lifting buddies, and we managed to abduct the patient and lash her securely to me on the back of the bike. I set out slowly and gave her the ride in Topanga she desired. There was outrage when I got back, and I thought I would be fired on the spot. But my colleagues—and the patient—spoke up for me, and I was strongly cautioned but not dismissed. In general, I was something of an embarrassment to the neurology department but also something of an ornament—the only resident who had published papers—and I think this might have saved my neck on several occasions.

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  I sometimes wonder why I pushed myself so relentlessly in weight lifting. My motive, I think, was not an uncommon one; I was not the ninety-eight-pound weakling of bodybuilding advertisements, but I was timid, diffident, insecure, submissive. I became strong—very strong—with all my weight lifting but found that this did nothing for my character, which remained exactly the same. And, like many excesses, weight lifting exacted a price. I had pushed my quadriceps, in squatting, far beyond their natural limits, and this predisposed them to injury, and it was surely not unrelated to my mad squatting that I ruptured one quadriceps tendon in 1974 and the other in 1984. While I was in hospital in 1984, feeling sorry for myself, with a long cast on my leg, I had a visit from Dave Sheppard, mighty Dave, from Muscle Beach days. He hobbled into my room slowly and painfully; he had very severe arthritis in both hips and was awaiting total hip replacements. We looked at each other, our bodies half-destroyed by lifting.

  “What fools we were,” Dave said. I nodded and agreed.

  —

  I liked him as soon as I saw him working out at the Central Y in San Francisco; it was early in 1961. I liked his name: Mel, Greek for “honey” or “sweet.” As soon as he told me his name, a string of mel-words ran through my mind—“mellify,” “melliferous,” “mellifluous,” “mellivorous”…

  “Nice name—Mel,” I said. “Mine’s Oliver.”

  He had a husky, athlete’s body, with powerful shoulders and thighs, and flawlessly smooth milk-white skin. He was all of nineteen years old, he told me. He was in the navy—his ship, the USS Norton Sound, was stationed in San Francisco—and he trained when he could at the Y. I too was training hard at the time, getting ready for what I hoped might be a record-breaking squat, and our workout times would sometimes coincide.

  After a workout and shower, I would run Mel back to his ship on my motorbike. He had a soft brown deerskin jacket—he had shot the deer, he said, in his native Minnesota—and I gave him the spare crash helmet I always kept on the bike. I thought we made a good pair, and I had a little tickle of excitement at his sitting on the saddle behind me and holding me firmly around the waist; it was his first time on a motorcycle, he said.

  We enjoyed each other’s company for a year—the year of my internship at Mount Zion. We would go on weekend motorbike rides together, camping out, swimming in ponds and lakes, and sometimes wrestling together. There was an erotic frisson here for me, and perhaps for Mel too. Erotic with the urgent opposition of our bodies, though there was no explicit sexual element, nor would an observer have thought we were anything more than a couple of young men wrestling together. Both of us were proud of our washboard abdominals and would do sets of sit-ups, a hundred or more at a time. Mel would sit astride me, punching me playfully in the stomach with each sit-up, and I would do the same with him.

  This I found sexually exciting, and I think he did too; Mel was always saying, “Let’s wrestle,” “Let’s do abs,” though it was not a purposively sexual act. We could work our abdominals or wrestle and get pleasure from it, at one and the same time. So long as things went no further.

  I felt Mel’s fragility, his not fully conscious, lurking fear of sexual contact with another man, but also the special feeling he had for me, which, I dared to think, might transce
nd these fears. I realized I would have to go very gently.

  Our bucolic and in a sense innocent honeymoon, with delight in the present and little thought of the future, lasted a year, but as the summer of 1962 approached, we had to make plans.

  Mel’s navy service was coming to an end—he had gone straight into the navy from high school—and he hoped now to go to college. I was committed to moving to Los Angeles for my residency at UCLA, so we arranged to share an apartment in Venice, California—close to Venice Beach and Muscle Beach Gym, where we could train. I helped Mel with the application forms to Santa Monica College, and I bought him a secondhand BMW, a twin to my own machine. He did not like accepting gifts or money from me and secured a job for himself in a carpet factory a short walk from our apartment.

  The apartment was small, a studio with a kitchenette. Mel and I had separate beds, and the rest of the apartment was filled with books and the ever-accumulating journals and papers I had been writing for years; Mel had very few possessions of his own.

  Mornings were pleasant: we enjoyed coffee and breakfast together and then going our separate ways to work—Mel to the carpet factory, I to UCLA. After work, we would go down to Muscle Beach Gym and then to Sid’s Café on the beach, where the muscle crowd hung out. Once a week we would go to a movie, and a couple of times a week Mel would take off on his own for a motorcycle ride.

  Evenings could be a strain: I found it difficult to concentrate and was very conscious, almost hyperaware, of Mel’s physical presence, not least his virile animal smell, which I loved. Mel liked being massaged and would lie naked facedown on his bed and ask me to massage his back. I would sit astride him, wearing my training shorts, and pour oil on his back—neat’s-foot oil, which we used to keep our motorbike leathers supple—and slowly massage his shapely, powerful back muscles. He enjoyed this, relaxing and surrendering to my hands, and I enjoyed it too; indeed, it would bring me to the brink of orgasm. The brink was okay—just; one could pretend that nothing special was happening. But on one occasion, I could not contain myself and spurted semen all over his back. I felt him suddenly stiffen when this happened, and without a word he got up and had a shower.

  He would not speak to me for the rest of the evening; it was evident that I had gone too far. (I suddenly thought of my mother’s words and how MEL were my mother’s initials—Muriel Elsie Landau.)

  The next morning Mel said tersely, “I have to move out, find a place of my own.” I said nothing but felt close to tears. He told me that some weeks before, on one of his evening motorcycle rides, he had met a young woman—not so young actually, she had a couple of teenage children—and she had invited him to stay in her house. He had put this off for the sake of friendship, but now, he felt, he had to leave me. He hoped, nonetheless, that we could remain “good friends.”

  I had not met her, but I felt she had taken Mel from me. I wondered, thinking of Richard ten years earlier, whether it was my fate to fall in love with “normal” men.

  I felt desperately lonely and rejected when Mel moved out, and it was at this juncture that I turned to drugs, as some sort of compensation. I rented the little house in Topanga Canyon; it was rather isolated, being at the top of an unpaved trail, and I resolved never to live with anyone again.8

  —

  In fact, Mel and I kept in touch for another fifteen years, although there were always troubling undercurrents beneath the surface—more so, perhaps, with Mel, for he was not fully at ease with his own sexuality and longed for physical contact with me, where I had, so far as sex was concerned, given up my illusions and hopes about him.

  Our last meeting was no less ambiguous. I was visiting San Francisco in 1978, and Mel arranged to come down from Oregon. He was curiously and uncharacteristically nervous and insisted we go to a bathhouse together. I had never been to a bathhouse; San Francisco’s gay bathhouses were not to my taste. When we stripped off, I saw that Mel’s skin, so milky and flawless before, was now covered with brownish “café au lait” patches. “Yes, it’s neurofibromatosis,” he said. “My brother has it too. I thought you should see it,” he added. I hugged Mel and wept. I thought of Richard Selig showing me his lymphosarcoma—were the men I loved fated to get terrible diseases? We said good-bye, shaking hands rather formally when we left the bathhouse. We never met or wrote to each other again.

  I had had dreams, in our “honeymoon” period, that we would spend our lives together, even into a happy old age; I was all of twenty-eight at the time. Now I am eighty, trying to reconstruct an autobiography of sorts. I find myself thinking of Mel, of us together, in those early, lyrical, innocent days, wondering what happened to him, whether he is still alive (neurofibromatosis, von Recklinghausen’s disease, is an unpredictable animal). I wonder if he will read what I have just written and think more kindly of our ardent, young, very confused selves.

  —

  While I took Richard Selig’s delicate disengagement (“I am not that way, but I appreciate your love and love you too, in my own way”) without feeling rebuffed or brokenhearted, Mel’s almost disgusted rejection affected me deeply, depriving me (so I felt) of all hope of a real love life, driving me inwards and downwards to seek whatever satisfactions I could find with drug-fueled fantasy and pleasure.

  During my two years in San Francisco, I had engaged in a sort of harmless weekend duplicity, exchanging my white intern’s jacket for animal skins and taking off on the bike, but now I was driven to a darker, more dangerous duplicity. From Monday to Friday, I devoted myself to my patients at UCLA, but those weekends I did not take off on my bike, I devoted to virtual travel—drug trips on cannabis, morning glory seeds, or LSD. These were secret, shared with no one, mentioned to no one.

  One day a friend offered me a “special” joint; he did not say what was special about it. I took a puff, nervously, then another, and then, voraciously driven, smoked the rest, voraciously because it was producing what cannabis alone had never produced—a voluptuous, almost orgasmic feeling of great intensity. When I asked what the joint had contained, I was told that it had been doped with amphetamine.

  I do not know how much a propensity to addiction is “hardwired” or how much it depends on circumstances or state of mind. All I know is that I was hooked after that night with an amphetamine-soaked joint and was to remain hooked for the next four years. In the thrall of amphetamines, sleep was impossible, food was neglected, and everything was subordinated to the stimulation of the pleasure centers in my brain.

  It was while I was wrestling with amphetamine addiction—I had rapidly moved from speed-doped marijuana to methamphetamine by mouth or vein—that I read about James Olds’s experiments with rats. The rats had electrodes implanted in the reward centers of their brains (the nucleus accumbens and other deep subcortical structures), and they were able to stimulate these centers by pressing a lever. They would do so nonstop, until they died of exhaustion. Once I was loaded with amphetamines, I felt as helplessly driven as one of Olds’s rats. The doses I took got larger and larger, pushing my heart rate and my blood pressure to lethal heights. There was an insatiability in this state; one could never get enough. The ecstasy of amphetamines was mindless and all sufficient—I needed nothing and nobody to “complete” my pleasure—it was essentially complete, though completely empty. All other motives, goals, interests, desires, disappeared in the vacuousness of the ecstasy.

  I gave little thought to what this was doing to my body and perhaps my brain. I knew a number of people on Muscle Beach and Venice Beach who had died from massive doses of amphetamines, and I was very lucky I did not get a heart attack or a stroke myself. I did and did not realize I was playing with death.

  I would be back at work on Monday mornings—shaken and almost narcoleptic—but no one, I think, realized that I had been in interstellar space, or reduced to an electrified rat, over the weekend. When people asked what I had done over the weekend, I would say that I had been “away”—how “away,” and in what sense, they probably did not gues
s.

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  By now, I had had a couple of papers published in neurology journals, but I hoped for something more—an exhibit at the upcoming annual meeting of the American Academy of Neurology (AAN).

  With the help of the department’s excellent photographer, Tom Dolan—a friend who shared my interests in marine biology and invertebrates—I turned from photography of western landscapes to the inner landscapes of neuropathology. We worked hard at getting the best possible pictures to convey the microscopic appearance of the hugely distended axons seen in Hallervorden-Spatz disease, vitamin E deficiency in rats, and IDPN intoxication in mice. We made these into large Kodachrome transparencies and constructed a special lighted viewing cabinet to illuminate the transparencies from within, along with captions to go with the photographs. It took months to put all this together, pack it up, and erect it for the 1965 spring meeting of the AAN in Cleveland. Our exhibit was a hit, as I hoped it might be, and I, normally shy and reticent, found myself drawing people over to the exhibit, expatiating on the special beauties and interests of our three axonal dystrophies, so different clinically and topographically yet so similar at the level of individual axons and cells.

  The exhibit was my way of introducing myself, saying, “Here I am, look what I can do,” to the neurological community in the States, just as my California squat record, four years earlier, had been my introduction to the weight-lifting community on Muscle Beach.

  I had feared that I might be unemployed when my residency came to an end in June of 1965. But the axonal dystrophy exhibit led to job offers from all over the United States, including two especially prized ones from New York City—one from Cowen and Olmstead at Columbia University, and one from Robert Terry, a distinguished neuropathologist at the Albert Einstein College of Medicine. I had become enamored of Terry’s pioneer work when he came to UCLA in 1964 to present his latest electron microscopic findings in Alzheimer’s disease; at the time, my interests were especially in degenerative diseases of the nervous system, whether they occurred in youth, like Hallervorden-Spatz disease, or in old age, like Alzheimer’s.