I think I first became aware of Oliver Sacks when I read his essay "The Twins" (which would later be included in the collection The Man Who Mistook His Wife for a Hat and Other Clinical Tales) in the February 28, 1985 issue of The New York Review. I found it absolutely riveting, in no small part because the style of writing was such a departure from the "scientific" (or, for that matter, "clinical") writing that I usually encountered in either the professional or popular press. However, it took at least a decade for me to cotton on to why his prose was as compelling as it was; and, having formed my hypotheses on this matter, I discovered, upon reviewing the Preface to The Man Who Mistook His Wife for a Hat, that they are confirmed by his own observations, but in a terminology different from my own. Since I have invoked my own terminology in several posts on this blog, I figured I would take the opportunity to discuss the extent to which I read Sacks' text as a confirmation of my own ideas.
The common theme that runs through my observations might be called an awakening (since Sacks used that for one of his titles) from a very long nightmare of positivism. The fact that I should have thought of positivism as a nightmare at all was probably a result of a rebellious spirit that emerged when I was doing my doctoral research in computer music, but I have social theorist Anthony Giddens to thank for helping me to take those unkempt rebellious thoughts and put them into a bit of order. Closely aligned with positivism is the "gospel" of scientific method; so, having been more than adequately prepared by my readings of Giddens, I was delighted to discover that the literary theorist Kenneth Burke had devoted much of his professional work to develop a theory of "dramatistic" thinking, which would serve as an opposition to "scientistic" thinking. Burke was enough of a Hegelian to recognize that this was an opposition that would not benefit from either side dominating over the other; but his own career was more than sufficiently filled with the study of "dramatism." So he left it for others to resolve the opposition through synthesis.
One can either try to theorize about such a synthesis or jump in and try to achieve it. In my few brief exchanges with Sacks, the topic of Burke and his theory never arose. I would not be surprised to learn that Sacks is totally unfamiliar with the man and his writings. Nevertheless, were he still alive, I suspect that Burke would quickly see the dramatistic element in Sacks' writings and probably discuss it as pointedly and eloquently as he would any literary source. Sacks, himself, actually acknowledges this synthetic aspect of his work when he writes about
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 dramatist [eureka!], am equally drawn to the scientific and the romantic, and continually see both in the human condition, not least in that quintessential human condition of sickness—animals get diseases, but only man falls radically into sickness.
What, then, is the nature of Sacks' particular approach to dramatism? To some extent it is a synthetic approach to a matter of form, the idea (which, as Sacks observes, goes all the way back to Hippocrates) that a case history is as much a narrative as a scientific account. From a scientistic point of view, the most important element in the documentation of a case is description; but in a case history (by the very virtue of its name) that description is achieved through historiography. This then brings us to the most important element of Sacks' literary style, which is that his historiography is achieved through a subject-based narrative. A case history is ultimately the history of the individual enduring sickness, as Sacks puts it, "the experience of the person, as he faces, and struggles to survive, his disease." Thus, the case history, as Sacks has chosen to write it, probably comes as close to a synthesis of "scientism" and "dramatism" as we are likely to get.
Sacks then threw yet another radical declaration at me in his Preface:
The patient's essential being is very relevant in the higher reaches of neurology, and in psychology; for here the patient's personhood is essentially involved, and the study of disease and of identity cannot be disjoined.
This immediately reminded my of my favorite dialogue by Plato, "Theaetetus," which tries to define the concept of knowledge, fails, but still leaves us recognizing that knowledge is hard to define because it is so tightly coupled to the concepts of description, being, and memory. The path to knowledge is a path that leads through description, but only because it leads through fundamental questions of being. Indeed, if one wanted to be really dramatistic, one could accord the status of "personhood" (or, as Burke would probably put it better, agency) to the disease as well as the patient, which would mean that the case history embodies that concept of αγών fundamental to Greek drama. From this point of view, one might then view Gerald Edelman's pioneering research in how antibodies work as being based on further endowing those antibodies with agency, making for αγών between both patient and disease and disease and antibody. In the essays that I have read, Sacks never goes quite that far over the dramatistic line; but I know from his writings that he has a high opinion of Edelman's theories about consciousness. Since those theories are, in many ways, an extrapolation of his antibody theories, my guess is that Sacks would see the dramatistic element of Edelman's model were it called to his attention (unless he has already done so).
I have one final observation about Sacks methodology, and this one reflects on my recent citation of Daniel Mendelson. To a great extent Sacks believes that, if you want to understand how the body works, then you need to observe it in circumstances where it doesn't work. You learn little from the healthy state beyond some good hypotheses about normative conditions and behaviors; and that is not, as they say, "where the action is." Healthy bodies, like Mendelson's "good people" do not "make good subjects for operas" (or any other dramatic form). To go back to the Greeks, it is through the study of αγών that we get to the heart of what Sacks calls the patient's "essential being;" so, while it would be a flattering exaggeration to call Sacks' case histories Homeric, there is at least a modest spirit of the Homeric bards about them.
This all leads back to my personal "agonizing" (so to speak) over the sorry state of liberal education. We still seem obsessed with specializing as quickly as possible, in order to jump in and start doing "useful things." We thus see the study of anything as unscientistic as literature as a waste of time that will not equip us with additional instruments for our toolkit. Sacks provides us with specific examples that illustrate the fallacy of this reasoning. Given how long he has been writing these examples, one would think that our educational institutions would wake up and smell the coffee; but their reasoning along these lines remains deep in slumber. As Goya once told us, that kind of slumber produces monsters!
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