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55 pages 1 hour read

Oliver Sacks

An Anthropologist on Mars: Seven Paradoxical Tales

Nonfiction | Book | Adult | Published in 1995

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Preface-Essay 2Chapter Summaries & Analyses

Preface Summary

Sacks opens the book by informing the reader that due to surgery on his right shoulder a month earlier, he needs to write with his non-dominant left hand. His body has adapted to this in a number of ways, including using his toes to grip objects when necessary. Some of these adaptations were intentional, while others he learned as he healed.

This is, Sacks proclaims, the ultimate paradox of disease and disorder: that while they may limit the human body in one way, “[O]ne may sometimes see them as creative too—for if they destroy particular paths, particular ways of doing things, they may force the nervous system into making other paths and ways” (xiv). Citing the work of neurologist A.R. Luria, Sacks posits that disorder and disease ought to challenge physicians to consider the brain not as a static or concrete organ, but one capable of ongoing evolution and adaptation. This is all the more extraordinary given the many small, vital parts of the brain that must work together in harmony.

The brain’s “remarkable plasticity” has changed the way Sacks views his own patients (xv). Whereas his earlier books tackled the subject of the preservation or loss of the self through disease and disorder, he has since realized that this is overly simplistic. Instead, Sacks recommends that physicians must try to understand the patients’ identities—“the inner worlds that patients, under the spur of illness, create” (xvi). He calls for attempting to better understand a patient’s reality, noting that it is not enough to merely observe behavior from a scientific point of view; the physician also needs to use their own intersubjectivity.

This intersubjectivity requires empathy and intuition, as well as a willingness to observe the patient outside a clinical setting. With this book, Sacks therefore leaves the hospital and doctor’s office in order to observe patients like an anthropologist or, as he describes it, a “neuroanthropologist” (xviii). This will allow him to study the wide variety of human experiences and metamorphoses in the wake of illness, disorder, and disease.

Essay 1 Summary: “The Case of the Color-Blind Painter”

Sacks receives a letter in March 1986 from an artist he calls Jonathan I. Jonathan is in his sixties and recently suffered a concussion in a car accident. Somehow, he has become completely color-blind, viewing the world in black and white. This letter stands out to Sacks because color blindness is typically something a person is born with rather than the result of a concussion; color blindness as a result of brain damage is called cerebral achromatopsia and is considered extremely rare. Sacks is intrigued by the opportunity to learn more about cerebral achromatopsia, particularly the physiological and psychological ramifications of an artist losing their ability to see color.

After receiving Jonathan I.’s letter, Sacks contacts his friend, ophthalmologist Robert Wasserman. Together, they meet Jonathan—a tall, gaunt smoker who fell into a depression after becoming color-blind. Jonathan suffered transient amnesia after the accident; he gave the police an account of what happened, but when he returned home to his wife he forgot about the accident entirely. When presented with the police report, he realized he could no longer read any written text, and when he entered his painting studio, he learned that he could no longer see his paintings in color.

Jonathan mourns the loss of color in his life even though he knows what objects around him are supposed to look like. He describes his color blindness to Sacks as a lens that makes the world look “dirty” (4). Greatly disturbed, Jonathan finds himself struggling to read traffic lights, and he does not wish to look at himself in the mirror.

Jonathan still sees tonal contrast and is able to differentiate the sharpness of a silhouette depending upon the lighting. Color television shows confuse him; black and white television shows are much easier for him to follow and watch. Desperate to convey just how troubling his new color blindness truly is, Jonathan constructs an all-gray room, painting the walls and furniture the same black, white, and gray shades that he experiences. Sacks points out that language failed Jonathan: “[…] [H]e said neither ‘grey’ nor ‘leaden’ could begin to convey what his world was actually like. It was not ‘grey’ that he experienced, he said, but perceptual qualities for which ordinary experience, ordinary language, had no equivalent” (8).

Jonathan can no longer enjoy art galleries, museums, music, or even rainbows. Regardless, he attempts to paint in color once again, but the flowers he paints are indecipherable to others even though he knows which colors he ought to use. Eventually, he embraces painting in black and white. Sacks says that these paintings “g[i]ve a feeling of violent forces—rage, fear, despair, excitement” (11). Over the following months, Jonathan’s paintings become more abstract, complex, and haunted, then less macabre, and more lively and sensuous. He also begins to experiment with sculpture.

Wasserman and Sacks are unsure if his color blindness can be reversed or even improved. After running several tests, they determine that he is suffering from achromatopsia—a cerebral rather than psychological disorder.

Sacks contextualizes Jonathan’s situation in the history of our understanding of color. In 1666, Newton proved that white light, when filtered through a prism, revealed itself to be a composite of many colors. Philosopher John Locke connected Newton’s understanding of light and color to the idea that our bodily senses could act as a source of information for us. Yet scientists still could not reconcile color blindness and achromatopsia with their understanding of reality and color. In the 18th century, Goethe declared that we composed the world around us, including the colors we see; certain wavelengths of light could be interpreted as a color, but color itself was an illusion. Edwin Land, creator of the Polaroid, simulated the differences between longer-wave and shorter-wave light, proving Goethe’s ideas about color as neurological illusion correct. Yet this illusion is central to our perception of the world, integrating itself into our memories and expectations of the world around us.

Sacks and Wasserman subject Jonathan to a test using a colorful geometric painting by artist Piet Mondrian under various kinds of lighting. They determine that he can differentiate between wavelengths, and that his visual cortex was not damaged, but that the V4 area of his secondary cortex was. They make glasses with green lenses that they hope will be able to help him discern color, but while they do reveal some color contrast, they don’t relieve him of his achromatopsia. Sacks describes how those with achromatopsia can see with the cones in their eyes but do not have the brain function to take in and differentiate colors.

Eventually, Jonathan begins to embrace his achromatopsia as a part of his artistic sensibility. A year after his accident, he claims to have forgotten colors. He is less focused on what he lost and says that he is “‘divorced’ from color” (33). He works in different kinds of lighting then he used to, including at night. His loss of color allows him to develop a form of night vision, becoming a part of what he calls the “night world” and making him “[…] the equal, or the superior, of ‘normal’ people” (34). Jonathan now views his accident and loss of color vision not as a loss, but as a privilege that allows him to see the world in a new way. When a physician offers Jonathan the chance to retrain the V4 section of his brain to see color, he declines, admitting he would once have been interested but now has a sense of visual order he does not want to disrupt.

Sacks is still unsure exactly what changed in regard to Jonathan’s higher brain function, describing him as a color amnesiac when he begins to forget his understanding of color. While there is still much we don’t know about the brain, Sacks is sure that “[I]f entire systems of representation, of meaning, had been extinguished inside [Jonathan], entirely new systems had been brought into being” (38).

Essay 2 Summary: “The Last Hippie Summary”

Greg F., a young man from Queens born in the 1950s, found himself swept up in the Summer of Love in 1967. After falling out with his parents, who wished he would settle down and pick a professional career, Greg joined the International Society for Krishna Consciousness led by Swami Bhaktivedanta in New York City. Eventually he moved to the Hare Krishna’s temple in New Orleans, where his vision began to dim. Swamis and others at the temple saw this as evidence of his inner life growing, and Greg did not seek medical treatment.

Three years into his stay in New Orleans, his parents decided to go and visit him. Upon seeing him again, they were shocked to see he had gained weight, lost all of his hair, wore a perpetual “stupid smile” on his face (41), had no sense of time or orientation, and was now completely blind. Alarmed, Greg’s parents rushed him to the hospital, where he was diagnosed with a midline tumor that had expanded down to the frontal lobes, destroying the parts of his brain responsible for his pituitary gland as well as his optic chiasma and tracts. Although the tumor was benign and was removed in 1976, neurologists could not reverse its effects on the brain. This somber diagnosis led Greg’s family to bring him to Williamsbridge, a hospital for the chronically ill.

Sacks meets Greg while working at Williamsbridge in 1977. He describes him as “fat, Buddha-like, with a vacant, bland face, his blind eyes roving at random in their orbits […] motionless in his wheelchair” (42). Although Greg responds when asked a question, he otherwise remains in silence or chants Hare Krishna songs to himself. Sacks is perplexed when he realizes Greg doesn’t know that there is anything wrong with him, and that he is indifferent to his condition. Some of Greg’s Hare Krishna brethren come to visit him, convinced that in his altered state he has achieved full enlightenment. Greg struggles to remember current events; he is stuck in the late 1960s, with few to no memories from 1970 onwards. He quickly forgets any new information.

A hospital social worker tells Sacks that Greg loves music, and they discuss Greg’s favorite band, the Grateful Dead. As Greg tells Sacks the story of the last time he saw them live, Sacks realizes just how strong his memories of the 1960s are, calling him “a fossil, the last hippie” (45). However, he remains perplexed as to how Greg does not know he is blind. As he examines Greg, Sacks learns that he is perpetually in the present moment and has no sense of the past or future and no interior life. Whereas the temple viewed this as a sign of devotion and transcendence, Sacks sees it as a lack of any kind of foresight: “He seemed to have no sense of ‘next’ and to lack that eager and anxious tension of anticipation, of intention, that normally drives us through life” (46). He is able to learn Sacks’s name, as well as the names of others he comes into daily contact with, and he makes his way around the hospital, but he is unable to place people or parts of the building within the larger context of his life.

Greg’s inability to retain new information and make new memories is due to damage to his medial lobes—specifically, the hippocampus and adjacent cortex. This damage prevents his brain from synthesizing sensations and passing them along from short-term to long-term memory. His placid demeanor, weight gain, and hairlessness are due to damage to his pituitary gland, which is in charge of hormone production. In addition, the diencephalon typically registers stimulation as well as basic bodily drives like hunger, libido, and more, all of which Greg has no desire for unless prompted. Greg wanders around the hospital if left unengaged, seemingly springing to life if someone speaks to him.

His parents, horrified by the change in their son, are particularly hurt by the change in his personality, as well as the strange affinity for wordplay and wisecracking that he seems to have gained. When he is around others, Greg seems alive, witty, and engaging, but he quickly falls into a dreamy stupor when alone. The anger and rebelliousness of his pre-Hare Krishna youth has dissolved. This phenomenon, called witzelsucht, or joking disease, is common in patients with orbitofrontal damage. Sacks characterizes Greg as existing in a strange, half-dreamlike state, feeling that the words “disorder” or “deficiency” don’t do justice to what is going on in his brain. Although the tumor has destroyed much of who he once was, he has become someone else. Sacks says he has grown into “another ‘kind’ of person” (54).

Sacks explains that the frontal lobes are the area of the brain that grow the most after birth, but their function and role has been hotly debated. Much of the mythology of the frontal lobes originated with the infamous story of Phineas Gage: a railroad foreman who sustained frontal lobe damage in the 1800s. He miraculously survived, but the damage to his frontal lobes caused radical personality changes: in Gage’s case, a complete lack of inhibition. Other similarly injured patients might grow listless or, in the parlance of the time, “insane.” This study of Gage and others with frontal lobe brain damage would eventually inspire the lobotomies and other psychosurgeries of the 20th century, many of which would cause serious physical and psychic damage to patients.

Sacks notices that Greg has a strong recollection of songs from the 1960s, and that he is able to learn to recognize some new songs as well. He is excited to see that Greg is able to memorize a limerick. However, Greg grows agitated when he is offered the opportunity to learn Braille. He insists he is not blind. Sacks begins to suspect he may have a deeper emotional life than what is immediately apparent, especially after he tells Sacks that he is miserable. Over the next decade, Greg retreats into himself further and further, unresponsive and uninterested in therapeutic assistance. When his father suddenly dies in 1990, Sacks breaks the news to him, but he forgets within a few minutes. However, Sacks notes that Greg is more withdrawn and less witty after this news. Staff find him wandering the hospital halls, lost and unsure what he is looking for. He may not be able to mourn in the ways that others do, but this behavior proves to Sacks that he does have a deeper, emotional sense of self.

Sacks learns that the Grateful Dead will be performing in August 1991 at Madison Square Garden, and he decides to take Greg to the concert; he is thrilled to see his patient sing along with the older songs the band plays. Despite Sacks offering him a chance to leave halfway through the concert, Greg insists on staying for the whole show. The second half mainly features the Grateful Dead's newer music, which Greg enjoys but cannot engage with in the same way. He tells Sacks he will always remember this night. But the next day, Sacks asks him about seeing the Grateful Dead, and he tells Sacks about the last time he saw them in Central Park back in the 1960s.

Preface-Essay 2 Analysis

In the first third of An Anthropologist on Mars, Sacks sets out his project for the essay collection: to consider the various ways neurological conditions, disorders, and damage can alter a patient’s sense of self. Sacks posits that neurological and biological changes are not always negative or even necessary to pathologize, but instead worthy of study and compassion in an effort to better understand how the human mind works. Each essay will focus on one person, their condition, its medical and scientific context, and what Sacks observes in regard to their physical, emotional, mental, and spiritual well-being as they navigate their world—sometimes in entirely new ways.

What sets this collection apart from Sacks’s other works is his description of himself as a “neuroanthropologist”: someone who studies neurological conditions from an anthropological perspective, blending medicine, social science, and personal experience. Unlike most clinical texts, Sacks is writing not merely to describe a diagnosis, but to illuminate just how mysterious our brains truly are, and how various neurological conditions reveal how our personalities, views, memories, and beliefs form. Each patient tests Sacks in some way, and by viewing and examining patients in their home environments—whether that be a home for the chronically ill or an artist’s studio—Sacks can get a holistic sense of how they view the world, and perhaps find a better, more fitting way to treat or help others moving forward.

Sacks writes each essay in a braided narrative form, following the story of a patient while incorporating science, medicine, history, culture, and other outside information. By blending each of these nonfiction subgenres together, Sacks places the patients within a larger clinical and societal context. Sacks’s essay collection is therefore accessible to anyone; while many of his readers may be interested in science or medicine, he does not assume that the reader has the same background or knowledge that he does. This context is particularly important when Sacks makes evaluations as a physician, such as when he teaches Greg a limerick. By introducing the reader to the neurological mechanisms he is examining, Sacks allows the reader to understand his own perspective on what is happening, as well as his sense of wonder when a patient defies his scientifically grounded expectations.

Sacks also brings his own experience to bear on the stories, narrating in first-person perspective when necessary. He does so only when referring to his own experiences with the patients, filling in the rest of their story using the information they and their loved ones have provided. For example, when telling Jonathan’s story, Sacks shares Jonathan’s initial letter describing his experience of color blindness before he delves into his own experience examining him. This allows the patient greater autonomy within their own stories, and as readers we have a much stronger sense of who they are than we would otherwise. This dovetails with Sacks’s broader project in the book; although the experiences of Sacks’s patients might at first seem foreign to readers, they ultimately hold universal lessons about the human mind.

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