Sacks begins by explaining to the reader that he is writing with his non-dominant left hand due to recent surgery on his right shoulder. As a result of this adaptation, he has developed various ways to compensate for the limitations imposed by his injury. For instance, he has learned to use his toes to grip objects when necessary. Some of these adaptations were intentional, while others occurred naturally during his healing process.
Sacks introduces the concept of the paradox of disease and disorder, highlighting that while they can restrict the human body in certain ways, they can also stimulate creativity. He quotes the work of neurologist A.R. Luria, suggesting that physicians should consider the brain not as a fixed and unchanging organ, but as a dynamic entity capable of continuous evolution and adaptation. This is particularly remarkable considering the intricate interplay of numerous vital components within the brain.
The author emphasizes that the remarkable plasticity of the brain has transformed his perspective on his own patients. In his previous books, he focused on the preservation or loss of the self caused by disease and disorder. However, he now recognizes the need for a more nuanced understanding. Sacks argues that physicians should strive to comprehend the inner worlds and identities that patients construct in response to illness. He stresses the importance of perceiving a patient's reality and advocates for the use of the physician's own intersubjectivity, going beyond a purely scientific observation of behavior.
To achieve this level of understanding, Sacks asserts that empathy, intuition, and observation outside of clinical settings are essential. He decides to adopt the role of an anthropologist, or what he terms a "neuroanthropologist," in order to study the diverse range of human experiences and transformations that occur in the aftermath of illness, disorder, and disease. By stepping outside the confines of the hospital and doctor's office, he aims to gain a deeper insight into the lives of his
patients and the ways in which they adapt and evolve in response to their conditions.
Sacks recounts the story of a letter he received in March 1986 from an artist identified as Jonathan I. Jonathan, a man in his sixties, had recently experienced a concussion in a car accident, resulting in complete color blindness. This intrigued Sacks because colorblindness is typically congenital rather than acquired through injury. The specific condition Jonathan developed is known as cerebral achromatopsia, which is considered extremely rare. Sacks is particularly interested in exploring the physiological and psychological implications of an artist losing the ability to perceive colors.
Upon receiving Jonathan's letter, Sacks reaches out to his friend, ophthalmologist Robert Wasserman. Together, they meet Jonathan, who is described as a tall, thin smoker. Following the accident, Jonathan fell into a state of depression. He experienced transient amnesia, forgetting about the accident entirely after giving his account to the police. When presented with the police report, he realizes that he can no longer read any written text. Upon entering his painting studio, he discovers that he can no longer see his paintings in color.
Jonathan expresses a profound sense of mourning for the loss of color in his life, even though he retains knowledge of what objects are supposed to look like. He describes his color blindness as a lens that renders the world "dirty." This loss deeply disturbs Jonathan, and he struggles to read traffic lights and avoids looking at himself in the mirror.
Although Jonathan can still perceive tonal contrast and distinguish the sharpness of silhouettes based on lighting, he finds color television shows confusing, while black and white shows are easier for him to follow. In an attempt to convey the true extent of his distress, Jonathan creates an all-gray room, painting the walls and furniture with various shades of black, white, and gray. Sacks emphasizes that ordinary language fails to capture Jonathan's experience accurately. Words like "grey" or "leaden" cannot adequately convey the perceptual qualities of his world.
Jonathan's loss of color vision robs him of the ability to enjoy art
galleries, museums, music, and even rainbows. Despite this, he tries to paint in color once again, but his paintings appear indecipherable to others, even though he knows which colors he should be using. Eventually, he embraces painting in black and white. Sacks notes that these paintings evoke emotions of violent forces such as rage, fear, despair, and excitement. Over time, Jonathan's paintings become more abstract, complex, and haunted, before transitioning to less macabre and more lively and sensuous compositions. He also begins experimenting with sculpture.
Sacks and Wasserman are uncertain whether Jonathan's color blindness can be reversed or improved. After conducting several tests, they conclude that he is indeed suffering from achromatopsia, a cerebral ratherthan psychological disorder.
To contextualize Jonathan's situation, Sacks delves into the history of our understanding of color. He references Isaac Newton's discovery in 1666 that white light consists of a composite of many colors when passed through a prism. Philosopher John Locke linked Newton's findings on light and color to the idea that our senses provide us with information about the world. However, scientists struggled to reconcile color blindness and achromatopsia with their understanding of reality and color perception. In the 18th century, Johann Wolfgang von Goethe proposed that we construct the colors we perceive, suggesting that certain wavelengths of light could be interpreted as colors, but color itself was an illusion. Edwin Land, the inventor of Polaroid, simulated the differences between longer-wave and shorter-wave light, validating Goethe's notion of color as a neurological illusion. This illusion is integral to our perception of the world, intertwining with our memories and expectations.
Sacks andWasserman subject Jonathan to a test using a colorful geometric painting by Piet Mondrian under different lighting conditions. They discover that he can differentiate between wavelengths and that his visual cortex is intact, but the V4 area of his secondary cortex is damaged. They create glasses with green lenses in the hope that they will help him perceive colors, but although they provide some color contrast, they do not alleviate his achromatopsia. Sacks explains that individuals with achromatopsia can still see with the cones in their eyes but lack the brain function to process and differentiate colors.
As time goes on, Jonathan begins to embrace his achromatopsia as
part of his artistic sensibility. A year after the accident, he claims to have forgotten colors. He becomes less focused on what he has lost and describes himself as "divorced" from color. He starts working in different lighting conditions, including at night. His loss of color vision allows him to develop a form of night vision, enabling him to become part of what he calls the "night world" and making him equal to or even superior to "normal" people. Jonathan no longer views his accident and loss of color vision as a loss but rather as a privilege that allows him to see the world in a new way. When a physician offers him the opportunity to retrain the V4 section of his brain to see color, he declines, as he has developed a sense of visual order that he does not wantto disrupt.
Sacks remains uncertain about the exact changes that occurred in Jonathan's higher brain function. He characterizes him as a "color amnesiac" when Jonathan starts forgetting his understanding of color. While there is still much to be learned about the brain, Sacks is convinced that if certain systems of representation and meaning were extinguished within Jonathan, entirely new systems have emerged in their place.
Sacks recounts the story of Greg F., a young man from Queens who became involved in the Summer of Love in 1967. After experiencing conflict with his parents, who wanted him to settle down and pursue a professional career, Greg joined the International Society for Krishna Consciousness led by Swami Bhaktivedanta in New York City. He later moved to the Hare Krishna temple in New Orleans, where he began to experience vision loss. The temple members interpreted this as a sign of his inner growth, and Greg did not seek medical treatment.
Three years into his time in New Orleans, Greg's parents visited him and were shocked by his physical condition. He had gained weight, lost all his hair, wore a perpetual smile, had no sense of time or orientation, and was completely blind. Alarmed, they rushed him to the hospital, where he was diagnosed with a midline tumor that had damaged his frontal lobes, pituitary gland, optic chiasma, and tracts. Although the tumor was benign and surgically removed in 1976, the neurological effects were irreversible. Greg was subsequently admitted to Williamsbridge, a hospital for the chronically ill.
Sacks encounters Greg in 1977 while working at Williamsbridge. He describes Greg as obese, with a vacant expression and blind eyes that rove randomly in their orbits. Although Greg responds to questions, he remains largely silent or chants Hare Krishna songs to himself. Sacks is puzzled by the fact that Greg is unaware of his condition and seems indifferent to it. Some Hare Krishna members who visit Greg believe that he has achieved enlightenment in his altered state. Greg struggles to remember current events and remains fixated on the late 1960s, with few to no memories from 1970 onward. He quickly forgets any new information.
Sacks learns from a hospital social worker that Greg loves music, particularly the Grateful Dead. As they discuss Greg's favorite band, Sacks realizes the strength of his memories from the 1960s, dubbing him "the last hippie." However, Sacks is perplexedby Greg's lack of awareness regarding his blindness. During his examination of Greg, Sacks discovers that he is constantly in the present moment, with no sense of the past or future and no inner life. While the temple interpreted this as a sign of devotion and transcendence, Sacks views it as a lack of foresight and anticipation. Greg can remember the names of people he interacts with daily and navigate the hospital, but he cannot place them or the hospital within the larger context of his life.
Greg's inability to form new memories and retain information stems from damage to his medial lobes, specifically the hippocampus and adjacent cortex. The damage prevents the brain from consolidating sensory input into long-term memory. His calm demeanor, weight gain, and hair loss are the result of pituitary gland damage, which affects hormone production. Additionally, the damage to the diencephalon hampers his ability to register stimulation and experience basic bodily drives unless prompted. Greg appears animated when interacting with others but quickly falls into a dreamlike state when alone. The change in his personality, characterized by an affinity for wordplay and wisecracks, is associated with orbitofrontal damage and a condition called witzelsucht or joking disease. Sacks describes Greg as existing in a peculiar half-dream state, suggesting that the terms "disorder" or "deficiency" fail to capture the complexity of his brain's functioning. The tumor may have destroyed much of Greg's previous self, but he has become a different person.
Sacks delves into the history of frontal lobe research, discussing the
case of Phineas Gage, who experienceda dramatic personality change after sustaining frontal lobe damage in the 1800s. This case, along with others, contributed to the understanding of the frontal lobes' role and function. The study of individuals with frontal lobe damage ultimately led to various psychosurgeries in the 20th century, with mixed results and significant side effects.
Despite Greg's significant memory impairment, Sacks observes that he retains a strong recollection of songs from the 1960s and can even learn to recognize some new songs. However, Greg becomes agitated when offered the opportunity to learn Braille, adamantly denying his blindness. Sacks begins to suspect that Greg possesses a deeper emotional life than initially apparent, especially when Greg expresses feelings of misery. Over the following decade, Greg becomes increasingly withdrawn and unresponsive to therapeutic efforts.
In 1990, when Greg's father passes away, Sacks breaks the news to him. However, Greg forgetswithin a few minutes, though Sacks notices that he becomes more withdrawn and less humorous afterward. Greg is found wandering the hospital halls, seemingly lost and unsure of what he is searching for. Although Greg may not mourn in the conventional sense, his behavior indicates a deeper emotional sense of self.
Sacks learns that the Grateful Dead will perform at Madison Square Garden in August 1991 and decides to take Greg to the concert. Greg enthusiastically sings along to the older songs, bringing a sense of joy to Sacks. Despite offering him the opportunity to leave halfway through the concert, Greg insists on staying until the end. However, during the second half, which features newer Grateful Dead songs, Greg is unable to engage with the music in the same way. When asked about the concert the following day, Greg recalls the last time he saw the Grateful Dead in Central Park during the 1960s.
Sacks discusses Tourette syndrome, which was first identified by Georges Gilles de la Tourette in 1885. He explains that individuals with Tourette's experience convulsive tics, involuntary mimicry or repetition of others' words or actions(echolalia and echopraxia), and involuntary or compulsive utterances of curses and obscenities(coprolalia). Sacks emphasizes that people with neurological conditions like Tourette's lead
"double lives," as they must tend to both their own needs and the management of their tics and compulsions. This can lead to challenges in understanding one's identity in relation to the illness, potentially leading to unproductive or harmful relationships with oneself. While Tourette's was previously viewed as a moral disease, the discovery of haloperidol in the 1960s provided relief from symptoms. However, Sacks encourages readers to see Tourette's as a fusion of the patient's inner and outer selves rather than solely a chemical, existential, or moral phenomenon.
Sacks introduces Dr. Carl Bennett, a surgeon whom he meets at a Tourette syndrome conference. Intrigued by Bennett's profession, Sacks accepts an invitation to visit him in British Columbia. Sacks observes that Bennett's tics and compulsions primarily involve touching his mustache, glasses, and objects in a symmetrical manner. Bennett can mostly control these symptoms while engaging in consuming activities like driving, but they resurface when he needs to stop at a red light. Sacks and Bennett discuss Bennett's relationship with his body and the surrounding space, particularly how proximity to stimulating objects or people can trigger specific tics andcompulsions. Bennett's anxieties and fears can also manifest in this manner.
Bennett's experience with Tourette's began at the age of seven, but he was not officially diagnosed until he was 37. The condition often isolated him from his peers but also fostered resourcefulness and independence. Despite facing difficulties in medical school and struggling to gain the trust of patients as a surgeon with Tourette's, Bennett eventually earned the respect of both his colleagues and patients.
Before witnessing Bennett at work, Sacks observes him starting his day by riding an exercise bike, smoking a pipe, and reading surgical texts to calm his mind. During his workout, he does not experience tics, but they return immediately afterward. At the hospital, Sacks is surprised to see how comfortable Bennett is with displaying his tics and compulsions in front of his colleagues, explaining that he is more cautious about expressing them in front of people he has just met. Sacks witnesses Bennett lying on the floor, kicking and thrusting one foot while describing a case of neurofibromatosis.
Sacks accompanies Bennett as he meets with outpatients. One patient requires a melanoma excision, and Sacks admires how Bennett manages his tics during the procedure, although he questions Bennett's decision
to show the patient the removed lump. In another case, Bennett feels compelled to explain the anatomical aspects of a procedure involving a T-tube in a patient's bile duct, but the patient eventually asks him to stop. Despite these moments, Bennett handles numerous patients with a warm bedside manner that defies expectations of someone with Tourette's. Sacks believes that patients sense Bennett's bravery, which engenders their trust.
The following day, Sacks observes Bennett performing a mastectomy, curious to see how he manages his Tourette's during a longer surgical procedure. Before the surgery, Bennett experiences intensified tics while scrubbing himself, but once the mastectomy begins, he successfully completes the complex procedure without any tics or compulsions surfacing. Bennett tells Sacks that he rarely thinks about having Tourette's while operating and theorizes thatindividuals with Tourette's can sometimes suppress their tics during activities that involve rhythm and flow, such as playing music, driving, or performing surgery. During these moments, Bennett feels most like himself.
After the mastectomy, Sacks and Bennett go for a swim in a lake. Sacks reflects on how much Bennett must suppress himself, recalling an incident where Bennett punched a hole in the wall of his office. Sacks contemplates the anxiety, panic,and anger that Bennett must constantly manage but never allow to overflow, especially in his work environment. While many individuals with Tourette's perceive their syndrome as an internal aspect of themselves, believing that their tics and compulsions are intentional, Bennett's inability to take haloperidol due to side effects leads him to consider Prozac a lifesaver.
When it is time for Sacks to return to New York City, Bennett, who has pilot training, offers to fly him to the nearby Calgary airport for his flight home. Despite his apprehensions and fears, Sacks agrees. As Bennett flies the plane, Sacks notices a childlike demeanor in him and wonders if Bennett's fascination with the spinning propeller and the attraction to risk, often experienced by individuals with Tourette's, can explain his affinity for flying. At such a high altitude, Bennett's Tourette's is less noticeable to others, allowing him to blend in as any other pilot. Bennett lands the plane safely, and Sacks watches as Bennett takes off again to fly himself home.
Sacks receives a phone call in October 1991 informing him of a man named Virgil, who has been nearly blind since childhood but has the opportunity to regain his eyesight. Virgil suffers from thick cataracts and retinitis pigmentosa, a genetic condition that gradually damages the retinas. Although there is uncertainty about whether Virgil truly has retinitis pigmentosa, his fianc?e Amy and her ophthalmologist encourage him to consider cataract removal surgery to determine if any vision remains. Virgil agrees to have his right cataract removed first.
Sacks, reflecting on a neurologist's career, sees this as an opportunity to explore the relationship between experience and vision. He ponders whether one needs prior visual experience to process the world and considers it a window into the intricacy of nature.
Virgil's visual impairment dates back to infancy when he suffered from meningitis, cat-scratch fever, and polio, leaving him with severely damaged retinas. At the age of six, he developed cataracts that further compromised his vision. Virgil attended a school for the blind and later became a massage therapist, establishing a modest life in Oklahoma. However, Amy feels that Virgil's lack of sight hinders his engagement with the world and hopes that restoring his vision will boost his confidence.
After the first surgery, Amy's diary notes that Virgil can see to some extent, which she considers a miracle. However, Virgil himself explainsto Sacks that he couldn't recognize anything until he heard his surgeon speak, realizing that the chaos of light and shadow formed a face. Unlike individuals who develop cataracts later in life, Virgil lacks prior visual experience, making it challenging for his brain to process what he sees. While he can perceive colors and movement, he struggles to identify them. Additionally, parts of his retinas have deteriorated over time, affecting his ability to focus his eyes. Amy hopes that his vision will improve further when they operate on his left eye.
Sacks and his colleague, Robert Wasserman, travel to Oklahoma to observe Virgil and conduct tests. Virgil's behavior appears neither that of a sighted nor blind person but more akin to someone mentally blind or agnosic. While driving, Virgil shows interest in moving cars and can identify changing traffic lights. However, he finds it challenging to read whole words, and his first visit to a grocery store overwhelms him visually. Despite these difficulties, Virgil can unlock his front door unassisted, a task he practiced after his surgery. However, he struggles
with stairs and is confused by his own shadow. Ironically, Virgil feels more disabled than ever, having lost the confidence he had as a blind person.
Sacks compares Virgil's experience to that of a newborn baby, who undergoes constant visual learning. Virgil, having forgotten most visual cues, struggles to learn and remember them anew.
The doctors and Amy take Virgil to a zoo, where he can identify specific features of animals but struggles to perceive them as a whole. During lunch, Virgil grows visually exhausted and experiences difficulty eating.
Virgil starts buying miniature toys to study real-world objects, animals, and humans through play. However, he experiences relapses when tired or confused, reverting to his previous routines as a blind person. Wasserman and Sacks are puzzled when Virgil's vision becomes inexplicably blurry for several days at a time. Sacks theorizes that Virgil's cerebral cortex may be overwhelmed, causing it to shut down and prevent neural overload. Virgil also tends to act blind around family members who are accustomed to his blindness. The struggle to adapt to his newfound sight and the discomfort of giving up touch causes himpsychological distress and eventually leads to deep depression.
Sacks notes that babies undergo a perpetual process of visual learning, which differs from the experience of newly sighted adults. Many individuals who gain vision later in life claim they neededto "kill" their blind selves to become "seeing" individuals, signifying a significant change in self and identity.
After Virgil's left cataract is removed, he resumes his work as a massage therapist. However, he is disturbed by seeing his clients' bodies, as they appear different from his tactile memories. He starts closing his eyes during massages to regain confidence. As he tries to adjust to a sighted life, he finds himself conflicted, unsure if he wants to change careers or engage in typical "sighted" activities like driving.
During Christmas, Virgil's family perceives a positive change in him, noting increased alertness. Sacks hopes their acceptance of Virgil as a seeing person will uplift his spirits. However, Sacks receives a call later in winter informing him that Virgil has developed lobar pneumonia and a collapsed lung, resulting in respiratory failure. Virgil's respiratory issues are complicated by his other health conditions, including Pickwickian syndrome. Strikingly, Virgil claims he cannot see, although Amy
observes that he still behaves like a sighted person. When Virgil is finally discharged from the hospital, he loses his job due to the constant need for an oxygen cylinder, leading to the loss of his home as well.
Amy insists that Virgil regained his sight and later lost it again. However, the doctors at his rehabilitation center inform Sacks that Virgil's only remaining visual perception is of colors. Perplexed by this turn of events, Sacks and Wasserman fly the couple to New York City for further testing. Virgil's deteriorating health is evident upon their arrival. Surprisingly, the tests reveal that his vision is worse than before the cataract surgeries. He can occasionally perceive shapes or objects but quickly forgets them. Sacks speculates that the sun's glare after the surgeries may have contributed to burning out what little remained of his retinas.
Despite Sacks's fascination with Virgil's story, he acknowledges the tragic irony of the situation. Virgil, caught between two worlds, ultimately loses his vision entirely.
the author discusses the artwork of Franco Magnani, who is featured in an exhibit on memory. Magnani has painted 50 artworks depicting his childhood home in Pontito, Italy, despite not having visited the place in 30 years. His remarkable memory and attention to detail have earned him the nickname "The Memory Artist."
The author ponders whether Magnani is an eidetic artist capable of holding scenes or memories in his mind for extended periodsand accurately reproducing them. Magnani invites the author to his home, where they tour his paintings of Pontito, while Magnani reminisces and reveals that painting what he remembers helps quiet his mind.
Magnani was born in Pontito in 1934 when the village had around 500 residents. The remote village, nestled in the Tuscan Hills, underwent little change throughout history until World War II. Following the death of Magnani's father in 1942 and the Nazi invasion, the townspeople were displaced. Upon their return after the war, many homes were defaced or destroyed, making it challenging for the residents to rebuild their lives. The population of the town decreased to 70 people. In 1946, Magnani left Pontito to attend school in Lucca, Italy. His paintings, however, depict
scenes prior to 1943. After training as a woodworker, Magnani attempted to return to Pontito but found no work available. He then lived and worked on cruise ships before eventually settling in San Francisco in 1965. During his travels, he rarely thought about Pontito.
At some point, Magnani developed a mysterious neurological condition for which he never received a diagnosis. While in the hospital, he began having vivid dreams of Pontito. Feeling a compelling force and a need to express himself, he started painting and drawing his memories of the village, despite having no formal artistic training. Over time, his visions of Pontito became more intense, extending even into daylight hours. He not only saw the place but also heard sounds and smelled the surroundings. The author draws a parallel to psychic seizures, in which patients experience commanding hallucinations and overwhelming nostalgia. The connection between sensation, emotion, and memory in the brain allows the patient to access vivid memories and feel transported to another consciousness.
Magnani grapples with this doubling of consciousness, feeling as though he is more often in Pontito pre-1943, even though he resides in San Francisco in the 1990s. The author describes him as living in a sort of half existence in the present due to the cost of his nostalgia and art. The author speculates that Magnani's condition, possibly temporal lobe epilepsy, provides an outlet for deep, complex emotions associated with his childhood home and family. Magnani was particularly close to his mother, and her death in 1972 devastated him to the point of temporarily ceasing his painting.
Despite his desire to return to Pontito, Magnani tends to self-sabotage before each trip, fearing that thereality may not match his memories. The author sees this as the paradoxical nature of nostalgia, longing for a past that has been transformed into a fantasy. In 1989, the author visits Pontito to see the sights in person and speak with Magnani's remaining relatives. While many of Magnani's paintings accurately depict the village, some are misleading, making it appear larger than it truly is. The author notes that strong memories are typical of temporal lobe experiential seizures and emphasizes the complex nature of memory. Regardless of their concreteness, Magnani's memories are always, to some extent, reconstructions.
The author suggests that Magnani's paintings represent a transfiguring vision of his childhood, with Pontito symbolizing the significant
peopleand the author theorizes that Magnani's lack of people in his paintings may be a way of preserving his childhood memories and connecting them to the place itself. Rather than viewing the paintings as mere fantasy, the author sees them as an intensification of memory.
When the author first met Magnani, the artist expressed concerns that returning to Pontito might mark the end of his memories and artistic inspiration. However, after the author speaks about Magnani at a conference in Italy, he starts receiving invitations to exhibit his work there, prompting him to finally return to Pontito. Although the town has changed in some ways, Magnani is embraced by the locals, who consider him a prodigal son. Upon returning to San Francisco, Magnani experiences an existential crisis as his childhood memories and present-day reality collide. Eventually, this conflict subsides, but Magnani claims to have lost the fantasy of Pontito and stops painting for a month.
In 1991, Magnani and the author return to Florence for an exhibit of Magnani's work. Afterwards, Magnani expresses a desire to visit Pontito again, but this time to spend time alone in the village and reconnect with it. They visit Magnani's sister, who now lives in Pontito. Magnani plans to sketch the town for a few weeks and reacquaint himself with its details. When he returns to San Francisco, he feels rejuvenated and motivated to continue his artwork. Although his paintings may not be dramatically different, Magnani is unsettled by how much Pontito has changed in his eyes. He decides against further visits, fearing that it may further compromise his memory and the fantasy he has created. Nevertheless, he remains committed to his promise to his mother to paint Pontito.
Sacks begins by discussing the case of "Blind Tom," an individual from the 1860s who was considered an "idiot savant," gifted in a particular area despite having a mental or learning disability. Sacks believes that Blind Tom would be considered autistic by today's standards. He then delves into the origins of the term "autism," which was described simultaneously by Leo Kanner and Hans Asperger in the 1940s. Autism is characterized by a desire for solitude or isolation, an obsessive insistence on sameness, difficulty with eye contact and understanding physical gestures, and intense focus on specific interests.
Approximately 10 percent of children with autism demonstrate singular talents, with many showing remarkable memory skills. Sacks cites the case of Nadia, a child with autism who displayed incredible talent for art in the 1970s. The study of individuals like Nadia persuaded scientists to investigate the neurological deficits associated with autism as well as potential abilities. Sacks receives a package in 1987 featuring the drawings of Stephen Wiltshire, a 13-year-old artist with autism. He is impressed by Stephen's accurate and lively drawings of buildings.
Sacks later discovers that Stephen is his brother David's patient. Stephen was born to West Indian immigrants in 1974 and exhibited delayed motor development as a child. He also struggled with eye contact and communication but showed an early talent for drawing. By age seven, Stephen became fascinated with drawing buildings and displayed an ability to draw them from memory with great detail. Chris Marris, a special education teacher, recognized Stephen's talent and provided support and encouragement for his art.
Stephen's drawings gained attention, and he received opportunities for exhibitions and a documentary. Despite his artistic success, Stephen's life remained limited in many ways. He could draw buildings with ease but struggled with independent navigation. Sacks reflects on the question of whether Stephen's talent can exist without a sense of self. In 1988, Stephen visits Sacks in New York City, where he draws Sacks's house with remarkable accuracy. Sacks observes Stephen's drawing process and considers it a reflection of his neural processes.
Marris had played a significant role in Stephen's life, but by 1987, he had moved to another school. Stephen's motivation to draw diminishes, leading Sacks to believe that he relied on others to facilitate his work. Stephen's literary agent, Margaret Hewson, takes him out on weekends to encourage his drawing, reigniting his passion. Sacks conducts tests with Stephen, and while thedrawings from memory differ from the originals, they retain the style of the initial drawings. Sacks ponders the inseparability of Stephen's talent from his autism and reflects on his portrayal of Stephen as a human being.
Sacks accompanies Stephen and Margaret on a trip to Moscow, where Stephen draws the Red Square and exhibits characteristic fluctuations in his emotional and physiological state. Sacks sees him as a perceptive observer but notes his difficulty appropriating experiences. During a visit to the Hermitage Museum, Stephen's interpretations of artworks surprise
Sacks. Stephen imitates Sacks's mannerisms during an "arithmetic lesson," reminding Sacks never to underestimate him.
Sacks tries to connect with Stephen when he visits London but senses a distance between them. Stephen's book, "Floating Cities," becomes a bestseller, yet he remains unfazed by his fame and continues to draw. Sacks reflects on the unique abilities of savants, noting that their talents are fully formed rather than developed over time. Savant talents may be linked to specific neuromodules activated by visual, musical, creative, or mathematical cues. These talents can also disappear as the child grows older, suggesting the ability to "turn off" theneural mechanism associated with their skills.
Sacks concludes by discussing the profound impact of encountering savants, noting that their abilities give the impression of something distinct and different in action. Unlike neurotypical talents, savant talents are fully present from the beginning and can be learned and remembered at an accelerated rate. This suggests a different neural mechanism at play. Savant talents can also fade as the individual grows older, indicating that the associated neuromodule can be deactivated.
The essay explores the fascinating world of prodigies and individuals with autism who possess extraordinary talents. It delves into the origins of autism, showcases the case of Stephen Wiltshire and his remarkable architectural drawings, and reflects on the nature of savant abilities and their neural underpinnings.
Sacks introduces Temple Grandin, whom he considers one of the most remarkable autistic individuals. He discusses the contrasting views of autism by Leo Kanner and Hans Asperger, where Kanner saw it as a catastrophic diagnosis, while Asperger viewed it as an originality of thought and experience. Sacks explains that autism is characterized by impairments in social interaction, communication, and imagination. He emphasizes the importance of understanding an individual's life story to grasp how their autism manifests.
Sacks is captivated by Grandin's autobiography, where she describesher early experiences with autism. As an infant, she exhibited sensory sensitivities and struggled with overstimulation. Diagnosed at
age three, she was initially nonverbal and was expected to be institutionalized. However, she eventually learned to speak and gradually overcame some of the challenges associated with autism.
When Sacks meets Grandin in person at Colorado State University, where she works as an assistant professor, he observes her straightforward and slightly awkward demeanor. Grandin discusses her interests in psychology, animal science, and engineering, which she attributes to her autism. She has a strong visual design sense and has used it to create innovative architectural designs for cattle slaughterhouses and farms. Sacks notes that her social skills are learned rather than naturally acquired.
During their conversation, Sacks asks Grandin about Greek mythology and Shakespeare, but she finds them perplexing and struggles with the nuances of human behavior. She likens herself to an anthropologist on Mars, trying to understand and imitate human behavior. Sacks accompanies Grandin on visits to farms and slaughterhouses, where she applies her knowledge of animal behavior to create more humane practices. He is amazed by her ability to connect with animals despite her difficulty relating to humans.
Grandin introduces Sacks to her "squeeze machine," which she built to provide the deep pressure sensation she craves but is hesitant to seek through physical contact. Sacks tries the machine himself and finds it reminiscent of his deep-sea diving experiences. They also discuss Grandin's work with cattle and her belief that animals should be treated with empathy and respect.
Sacks learns about Grandin's childhood experiences, her enrollment in a school for children with disabilities, and her gradual improvement in communication skills. Although she struggled with social interactions, she compensated with her intellectual efforts. Grandin relates to the Star Trek character Data, who struggles to understand human emotions, and she sometimes wishes she could be "normal."
They visit a slaughterhouse that Grandin designed, where she aims to eliminate fear and stress in the animals before their death. She emphasizes the need to treat animals with dignity and challenges the notion that their emotions are less valid than humans'. Grandin's connection with cows runs deep, and she is sought after for her expertise in designing humane ranches and slaughterhouses worldwide.
Sacks discusses Grandin's views on neurotypical visual learners and
her belief that her brain is organized in a modular fashion, with different "intelligences" compartmentalized. Grandin mentions her lack of romantic andsexual experiences and her inability to experience love and passion for another person. However, Sacks questions this, citing the passions and tenderness he has observed in other autistic individuals. Grandin continues to seek new models and systems to better understand her autism and states that she would not give up her autism if given the choice.
Finally, Grandin accompanies Sacks to the Rocky Mountain National Park, even though she does not have hobbies or take time off herself. While she agrees that the mountains are pretty, she may not categorize them as "sublime" in the same way as Sacks does. Nevertheless, she appreciates the beauty in her own unique way.