Guest Post: Walking With Oliver

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L0028360 A surgical operation: total knee replacement. Drawing by Vir Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org A surgical operation: total knee replacement. Drawing by Virginia Powell, 1997. Lettering: Total knee replacement 16/1/97 Virg- Powell Observed at Chelsea and Westminster Hospital, Fulham Road, London. In the foreground are trial moulds for different sizes of artificial knee, some red, some mauve, some green. Copyright The Wellcome Trust Drawing 1997 By: Virginia PowellPublished: 16 January 1997 Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

In 1974, the neurologist Oliver Sacks was hiking alone on a Norwegian mountain when, coming around a boulder, he stumbled upon a bull sprawled across the trail. The bull didn’t react, but Sacks, no stranger to hallucinations, somehow imagined the animal as “first a monster, and now the Devil.” As he fled downhill in a deluded panic, he slipped, dislocating his patella, tearing his quadriceps from the knee, and rendering his leg “limp and flail… [it] gave way beneath me like a piece of spaghetti.” Unable to walk, he nearly perished of exposure before kindly reindeer hunters discovered him and toted him down the mountain.

Though Sacks survived, the worst trial was yet to come. In the wake of knee surgery, he struggled to see his unresponsive, “sepulchral” leg as his own: It “felt like wax — finely molded, inorganic and ghostly.” A phantom limb, all the creepier for still being attached. The experience unnerved Sacks, a vigorous young doctor forced into the passive role of patient. He had diagnosed the man who mistook his wife for a hat; now Sacks had become the neurologist who mistook his leg for a block of marble. “For what was disconnected,” he fretted, “was not merely nerve and muscle but… the natural and innate unity of body and mind.”

The book Sacks wrote about his bizarre and arduous recovery is called A Leg to Stand On. It’s a spare, self-contained account, not generally granted an exalted place in his pantheon. Many of his casual fans — the ones who know him as the avuncular Brit who often popped up on RadioLab to chat about face-blindness — likely don’t realize it exists. Yet Leg is his most personal book, the work in which Sacks himself confronts the same bewildered terror as his patients:

Had ever I faced a more paradoxical situation? How could I stand, without a leg to stand on? How could I walk, when I lacked legs to walk with? How could I act, when the instrument of action had been reduced to an inert, immobile, lifeless, white thing?

Several decades after Oliver Sacks destroyed his left knee, I wrecked mine — a similar case, incurred in dissimilar fashion. (My Norwegian mountain: a basketball court in a Massachusetts trailer park.)

Though my injury was less catastrophic than Sacks’, I, too, lay immobile for weeks, sweating through nightmares in which my own leg had literally rotted to its core. I spent that summer lying on an uneven mattress in an airless upstairs room, my left leg wrapped in a massive brace, a Velcro-and-foam apparatus that absorbed and re-emanated the sick smell of my own sweat. I saw my scarred knee but once a day, when I swaddled it in Saran wrap to shower.

Locked in its cumbersome tomb, my quadriceps atrophied into a limp slab, reminiscent, in color and texture, of bacon fat. On a physical level, my leg revolted me. Worse, though, was the sense of betrayal, as though my dislocated kneecap and shredded patellar meniscus had conspired to sabotage me. My body had become a stranger to my mind, and my recovery languished as I wallowed in self-pity.

At some point during that miserable summer, my father — a physician who dabbles in Sacksian creative nonfiction — gave me a copy of A Leg to Stand On. I did not, at the time, know Oliver Sacks from Oliver Twist, but I opened it. After all, what else was I doing?

It would not be an exaggeration to say that Leg was the most important book I had yet read. Sacks transformed the way I regarded my own body: Every obstacle that I faced, he had surmounted. (“The first step! In my efforts to stand, to gain control, I had thought only of holding-on, of survival… Now, I thought, I might try to move.”) Every grim thought lurking in the dark peripheries of my consciousness, he lit up. (Watching a school team play rugby: “I hated their health, their strong young bodies… I looked at them with virulent envy, with the mean rancor, the poisonous spite, of the invalid… Nor could I bear my own feelings, the revealed ugliness of myself.”) Our stories even seemed to share a cast of characters: the gifted but distracted surgeon who views himself as carpenter; the brusque nurse; the physical therapist brimming with bonhomie.

Most of all, A Leg to Stand On captured the emotional turbulence of injury — the agonizing depths of infirmity, the ecstatic highs of convalescence. One minute, Sacks was despondent, convinced that he couldn’t feel his leg because he’d suffered a stroke that would leave him forever wheelchair-bound; the next, he was euphoric at seeing his toes return to life, “as if twiddling in mirth at my absurd train of thought.” The lows, then, became a normalized part of my healing process, and even the mundane rituals of physical therapy — the stationary bike, the electroshock stimulation — came to feel sanctified, the means of repairing the schism within myself.

Like an Anne Sullivan of the orthopedic, Oliver Sacks gave me language with which to consider my condition. My injury wasn’t that severe, of course, and full recovery was all but inevitable. Still, he made it swifter, more enlightened, and less lonely. For that, I was grateful.

Sacks, of course, died on Sunday, at the age of 82, after a public and all-too-brief bout with cancer. It is hard to know where to begin eulogizing someone who was so many things to so many people: brilliant clinician; resuscitator of narrative medicine; understated symbol of forbearance in the face of homophobia. He taught the world how to use LSD, how to appreciate music, how to die with grace. He looked studly on a motorcycle.

And he showed me, too, the joy and beauty inherent in that simplest, most confounding act: relearning to walk.

Now the time for thinking was over, and the time for doing had come; now — and for the weeks ahead — my flight would be swift, intuitive, unreflective; I would return to my body, my being, the world, to the special adventure of convalescence and rebirth; I was to come alive again, and know life, as never before.

 

Ben Goldfarb is a correspondent for High Country News.
Top image: A surgical operation: total knee replacement. Courtesy of Wikimedia Commons and Virginia Powell.

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