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Question: Can you discuss conflicting approaches to discussing and treating neurological disorders?

Oliver Sacks: A neurologist, as a physician, expects people to come to him with problems, people who are suffering, who are disabled, who have complaints. It is extremely unusual, for example, to receive, as I mentioned earlier, a letter from someone who describes an achievement, like my lady who said that she had suddenly achieved stereovision, and her life had been wonderfully enlarged.

Most of the people who come to me say their life has been diminished or shrunken or affected by whatever it is. But, having said that, and as a physician, if the disease or problem can’t be treated as such, which may be the case, there may be some forms of brain damage or spinal damage, which are there, you have to accept it.

Then the real challenge is to find other ways of living and making the fullest possible life and identity; using, if you want, sort of other parts of the brain and compensating.

I’ll give you a specific example. It’s easier for me to think on specific terms. I was consulted by a novelist who on one occasion, he had breakfast. He felt fine. He went to get a newspaper outside. In fact, it was the Toronto Globe and Mail, and he found it unintelligible. Clearly, it was the newspaper, but he couldn’t make anything of the print. He had a momentary feeling that a paper was printed in Serbo-Croat or something. And he had what’s called a visual alexia. He’d had a small stroke effecting the visual parts of the brain.

And for a writer, above all people, to be suddenly unable to read, interestingly, he was able to write, but he then couldn’t read what he had written. And he was devastated by this; didn’t know how he was going to survive as a writer or as a person.

After a while, it seemed to him that he was learning to read again, that he was recovering. But, in fact, when he was tested, there was no recovery of the visual alexia.

What was happening, unconsciously, was that his tongue was copying the shapes of letters on his palate. And since the disease only affects the visual, basically, he was reading with his tongue.

So part of my work as a neurologist is to find and help people discover other ways of doing things.

Tourette's Syndrome can make life very difficult for one. But, in a sense, there can be another side to it as well, because one’s thoughts are accelerated, one’s coordination may be particularly quick in motions and imagination, may be stimulated, and there’s a sort of positive side to this, in a way, Tourette's is a turned-on state.

And this can sometimes be utilized. There’s some very good athletes with Tourette’s. There are good musicians and performers with Tourette’s. And perhaps if one sees someone with something like Tourette's Syndrome, it’s good to explore possible, positive sides of it.  I don’t say there’s always a positive side, but I think it’s very important to look and not just simply to think in terms of defects and problems, but of different ways of doing things and different ways of functioning.

And this has now become almost a political thing. So let’s say, people with autism will like to refer, sometimes almost contemptuously, to the rest of us as neurotypical.

I think the idea of neurological differences and styles is very important, although one can go over the top with it. It’s a delicate matter.

Recorded on: September 4, 2008

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