How Oliver Sacks put a human face on the science of the mind - The world’s most famous neurologist believed that every patient had a story worth hearing.
Norman Doidge explores the legacy of Oliver Sacks, whose work and life remind us that humanity belongs at the heart of medicine.
Oliver Sacks’s legacy was to restore a vision of a humane medicine that drew its power not from technological breakthroughs alone, but through the healing power of the doctor-patient relationship. It had roots in a more old-fashioned view that came in part from his general-practitioner father, who had close relationships with his patients and did frequent house calls. It was a form of care that required an almost unheard-of immersion in the lives of his patients by Dr. Sacks, which allowed him to draw portraits of human beings of an incomparable subtlety and sensitivity, while shedding new light on the mysteries of the brain. He also rejuvenated for us the rich tradition of the case history.
Yet Dr. Sacks’s triumph did not come immediately or without opposition.
“[W]ith little encouragement from my colleagues,” he wrote, “… I became a storyteller at a time when medical narrative was almost extinct. … It was a lonely but deeply satisfying, almost monkish existence that I was to lead for many years.”
It may sound a strange claim, but the detailed case history – which in the 19th century produced some of the finest descriptions of patients ever written – had all but disappeared from the neurology journals when Dr. Sacks started writing, and, even today, it is rare. The great 19th-century neurologists, lacking scans, EEGs, and statistics, perfected their observational skills and the art of talking to patients so as to help them describe how those patients’ mental experiences were altered by their brain problems.
With the advent of modern lab and scanning techniques, these observational and communicative skills atrophied. The journals changed, too. Detailed accounts of individual patients increasingly disappeared, replaced by group studies of “subjects,” described in more abstract, statistical terms, based on their scans and scores on tests. Instead of reporting what was unique about a patient, studies reported what was average about a population. And averages smear out what is unique about individuals.