Letters, page 65
All this, of course, depends on our own physical and moral survival as a species—our not blowing ourselves up, or destroying each other, or destroying our so-vulnerable planet; but becoming more decent, and more civilized—wiser—as well as more “advanced,” in the future.
Yours sincerely,
Oliver Sacks
To Peter Singer
Philosopher, Author of Practical Ethics and Animal Liberation
September 9, 2000
2 Horatio St., New York
Dear Dr. Singer,
When Daniel Halpern[*43] sent me a proof of your forthcoming Writings on an Ethical Life, I excused myself from providing a comment on the grounds that the issues you raise were “too deep and complex” for me to venture a comment without a careful perusal of the book, and that I was too involved in writing a new book of my own to give it the time it needed. All this was true, but not perhaps the whole truth—I have to confess that I had an incorrect idea of your viewpoints, because (to my shame) I had never read any of your works, tho’ I had heard various misrepresentations of them. Now, having opened your new book, I have had to read straight through it (I have not yet quite finished), and I am so impressed by what I read that I feel I must write to you. I now strongly agree that this accessible “essential” Singer is an extremely good idea, and that its publication is very important.
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I think I was introduced early (perhaps too early) to some of the considerations you raise, because my parents were physicians, and my mother, in particular, an obstetrician. When I was ten or so she told me how she (and the Matron or Nursing Sister in a Nursing Home) might drown anencephalic infants, or infants with severe spina bifida, at birth—“like a kitten”—and how if the head was too big to pass through the pelvis it might be crushed by a cranioclast. She sometimes brought these deformed or killed fetuses back to the house, and wanted me to dissect them. Thus (for me, as a ten year old) the obvious commonsense of what she did was infused or associated with a kind of horror. I do not know whether these drownings were first discussed with the mother or not.
As a medical student (more than forty years ago, in London) I was the “extern” on the Medical Unit when a friend of mine, a young man, a fellow-swimmer, was admitted with odd symptoms which turned out to be due to acute leukemia. Medications did not slow his disease, and he soon started to have unbearable pain from the development of leukemic deposits in the spine. When he realized that nothing could be done, and that only extreme and increasing pain lay ahead he said he wanted to die, and one day I found him climbing over the railing on the balcony outside the ward. I pulled him back and prevented him throwing himself over. Subsequently his pain became so great that nothing—not even heroin—could hold it, and he screamed constantly, day and night, in agony, unless he was given a general anaesthetic. He cursed me for having prevented his suicide.
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As a physician, a neurologist, working for the most part with gravely ill patients, or patients with long-standing (or lifelong) neurological disease (or damage), I often face—or avert my face from—some of the ethical considerations you raise. Perhaps I should say, rather, that I often keep my thoughts to myself. Twenty-five years ago or so I saw in our hospital a young woman who had suffered a devastating herpes encephalitis, and had been in a coma (with “decerebrate rigidity” and a profoundly abnormal EEG) for five years. She was never visited by her family, who wished she would die; but youth, and “good care” (tube-feeding, toileting, intermittent use of antibiotics, etc) kept her alive. I suggested, in my note on her, that she should be allowed to die, since she was incorrigibly and profoundly brain damaged, with no consciousness or prospect of consciousness, and because her life offered nothing positive to herself or anyone else. My then chief, the Director of the Hospital, was horrified by my suggestion, and said that I “belonged in Auschwitz.”[*44] When I protested that there was all the difference in the world between a truly hopeless patient such as this, and my Awakenings patients, or other patients in whom I was often the first to perceive or evoke the potentials for consciousness and improvement, he was unmoved. The young woman “brain-dead” from herpes encephalitis is still alive—she has been maintained now, in her coma, for thirty-two years.
I am not in private practice, and to some extent, therefore, I can or may avoid certain responsibilities, or at least direct actions, while feeling free, as a “consultant,” to discuss these with others. In a way which is either cowardly or “diplomatic” I refrain from stating my thoughts in public, even the (mildly) public form of hospital notes. I don’t want to be called a Nazi again, nor outrage the sensibilities of those whom I work with (one of the chronic-disease hospitals, the “Homes,” I work in is orthodox Jewish, and one is Catholic, run by nuns). But when I see patients who have suffered profound and irreversible brain-damage—whether from something like herpes encephalitis or a stroke, brain-injury, or the terminal stages of Alzheimer’s disease (no-one is more active than myself in finding ways of approaching, or making life more worthwhile for patients with only mild or moderate dementias)—I will make a point of discussing their now purely biological (rather than biographic) lives with their relatives and their immediate caretakers, at least opening up the possibilities of discussion (and perhaps action) on a subject which seems so taboo, but is also so forced upon one now in the present state of Medicine. I wonder now, after reading some of your extremely clear (and candid and courageous and consistent) writings whether I should not “come out” myself on some of the issues you raise. But this is something I must think on, and these are my (as yet) private thoughts.
I have not had much philosophical background (though I did go to some of A. J. Ayer’s conferences in the 1950’s, when I was a medical student in London), but (as you say) “moral philosophy” at that time had little to do with the real world. I read Moore’s Principia Ethica, and I read (immaturely) a little Bentham and Mill. Later, I read some Bonhoeffer, about “cheap” and “costly” Grace, and, in particular, his final essay in Ethics on “What is Meant by Telling the Truth?” This, if I understand what he was saying, was an exploration of how to tell it to the right people, in the right way, at the right time, which might have seemed a prescription for equivocation—but his own truth-telling, of course, landed him on a Nazi gallows. Reading your Writings on an Ethical Life brings home to me that I have not read any such writings for the last thirty years—and the beauty and importance of such writings, at least in hands such as yours. How (or indeed whether) I can/will be affected by such writings—relatively late in my life (I am in my sixty eighth year now)—I do not know; but I am very glad that Dan sent me the proof, and that (in a sense) I have made your acquaintance.
And I think it will be tofu, not tuna, for lunch!
With my best wishes to you, and for the new book,
Oliver Sacks
PS I think I have to differ from you (though I am not sure of the consequences of this, in ethical terms) regarding the uniqueness or otherwise of Homo sap. I think that there is not just a difference of degree, but a difference of kind, between human beings and the great apes (even though they have the beginnings of self-consciousness, and can acquire a considerable lexicon—I am not sure if it can be called a language—of signs). Language (for what it is worth) seems to be species-specific—thus a microcephalic “idiot,” with a brain smaller than a dog, may automatically acquire a vocabulary such as the brightest ape, with intensive teaching, cannot. This may make it difficult to make direct comparisons, as on a scale, between human infants, retarded children etc. and other species. Having worked with severely retarded children (and adults), I would hesitate to characterize them as “non-persons.” I would very much like to have worked with chimps and other apes—I am (as it happens) having breakfast with Jane Goodall tomorrow. Perhaps one needs a special (moral) discourse for human beings, and one which does not stem from “speciesism” or bias.
While a biographical consciousness may be (more or less) confined to human beings,[*45] I think that biological consciousness, and the capacity to feel pain and suffer, developed, must have developed, quite early in evolution. Having had dogs and cats (though I am not especially an “animal-lover”) I cannot doubt their capacity to feel—and my horror at the sufferings of cattle led to slaughter (I describe this in An Anthropologist on Mars) was certainly a factor disposing me to avoid meat. I am now, with uncertain feelings, chiefly a fish eater—I persuade myself that fish feel less—though I avoid eating squid, octopus, cuttlefish (which I suspect to have almost-mammalian intelligence and emotions). I am tending, gradually, to vegetarianism.
I am confronted, almost daily, with dilemmas about patients. I (have to) regard human beings as “persons” so long as there is any vestige of consciousness left, and I feel the feeble and intermittent consciousness of the profoundly retarded or demented as essentially human even though it may lack foresight, retrospect, the biographical sense of a life. I believe that this is a valid observation, and not a reflection of self-indulgent speciesism.
To Lewis Wolpert
Developmental Biologist
February 25, 2001
2 Horatio St., New York
Dear Lewis,
Many thanks for your letter and your (Telegraph, Jan 24) article on Belief. […]
On the whole I very much like the thrust of your piece, which (I take it) will be the thrust, or one of the thrusts, of your book. I do think that there is, with us, a built-in need to tell stories, make narratives, make narrative sense of the world (physical, social etc.); narrative thinking develops very early, long before “paradigmatic” thinking (I very much like Jerry Bruner’s book on these two forms of thought)—and one sees it hugely developed, for example, in people with Williams syndrome (along with their verbal and social precocity generally), along with profound defects in their comprehension of the simplest logical operations (especially spatial ones). What has especially fascinated me is the almost frenetic (and obviously, to the person, vital) story-telling which I describe, for example, in “A Matter of Identity” (Hat). And if it cannot be a rational story, it will be a fantastic one.
The need for causality, or an idea of causality, also seems to be very deep or fundamental in human nature—but I would not agree with you that, in its most elementary forms, it requires language. And indeed you yourself note, later in the piece, that “infants in the first year of life perceive the causal structure of simple collision events” etc. It does seem almost species-specific—one is amazed at the “elementary” mistakes which even the great apes make. By the same token, violations (or seeming violations) of causality are very shocking—I think here of the intellectual shock of quantum mechanics, and Einstein’s obstinacy in the face of a seemingly statistical universe.
The question of scientific beliefs seems to me a complex one—for while they should be provisional, and subject to revision, they may be charged with an almost religious or mystical force, an emotional conviction, and an emotional investment, which makes them rather like religious beliefs, and as hard to give up. I think here of Eddington[*46]—and his numerical-cosmogonic System—and his intellectual intransigence and aggressiveness when faced with contrary data and concepts (notably by Chandrasekhar).
I think (but will not dilate on this, because I know it is one of your “things”!!) that you go too far in ranking psychoanalysis with astrology, telepathy, homeopathy etc. I fully agree with you about the latter (Freud himself spoke about “the black mud of the occult” here), but a certain amount of psychoanalysis, at least (tho’ by no means all), seems to me to allow of experimental or experiential confirmation (or refutation), and to have the requisite qualities of scientific hypothesis. The fact that many people treat it as a religion, or a cult, is neither here nor there. They are indeed an embarrassment to genuinely-striving psychoanalysts.
E. M. Forster, as you know, starts one of his essays with “I do not believe in Belief,” and this is a sentiment to which I resonate, because I have never been sympathetic to religious or political or ideological convictions—and have been bewildered when I saw some of my friends carried along by these. On the other hand I do believe (but very quietly) in the methods of science, and if my strongest need is need for order, I will not accept any order other than that generated by a slow and patient science.
I have written too much, but you asked me to write.
I’m not up to thinking of mystical or hypnotic experiences in this letter—maybe another one. I hope you have had some personal experience of both—it helps! As it helped Williams James.
Will you also write about belief (if this is the right word) and Art—the profound sense of “truth” or “verisimilitude” which a great painting or poem can induce—or will this stray too far from an already dangerously-large theme?
Do you know Maynard Keynes’ memoir “My early beliefs”?
I have just (after 3½ years!) finished my own “memoir” of boyhood, and science etc—which is partly (I suppose) about the evolution and turmoil of my own beliefs as a boy, and certainly my need for causality and order.
I hope you are well—you certainly sound productive!
With warmest regards,
Oliver
To Frank Kermode
July 16, 2001
2 Horatio St., New York
Dear Frank,
I have finally completed (or abandoned) Uncle Tungsten—and have taken the liberty of asking Picador to send you a proof (it comes out in November).
I struggled with it for three years or more—often feeling that the attempt to weave together a personal and a scientific-historical narrative was an impossible or doomed one—but then, for better or worse, it all seemed to come together.
One takes leave of such things—as you, above all, know!—with very mixed feelings, relief and regret combined: “resurrecting” parents, early experiences, loves, hopes, passions, disappointments, and then leaving them (having imprinted them with one’s transformations and distortions etc) once again. I think I feel a little more “accommodated,” a little calmer, since writing Uncle T—as if doing so put some of my life in perspective for me; but whether the book will have resonances for others is not something I can judge for myself.
I have no impulse to continue, to add a Part II etc, and have turned with relief to an entirely different writing project—writing about a trip to Oaxaca last year, which though primarily botanical, led me in all sorts of other directions too, all the wonder (and sometimes horror) of meso-America. I read Prescott[*47] as a boy, and it all came flooding back to me. Though my own interest, especially, was in the stuffs the New World gave us—chocolate, cochineal, rubber, tobacco, etc etc, and the extraordinary agricultural knowledge they had. But it was great fun to be with the American Fern Society—to see the enthusiasm (and energy, and erudition) of these often marvellous amateurs—and to be reminded of the importance of amateurs in science—at least the “field” sciences, like geology and botany.
I continue to see long, grand reviews by you in the NYRB on all sorts of topics—and I was deeply interested in your thoughts on memory etc. in Index.[*48] I wish I had your ability to write these somehow compact yet complete pieces on such a range of topics, but I feel, more and more, that I have to write books—at least as long as I can, and I am afraid of getting “diverted” from this.
I hope you are well, and that I can see you, perhaps, when I come to England for the publication of Uncle T in November/December.
With kindest regards,
Oliver
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On September 11, 2001, the World Trade Center towers were destroyed in a terrorist attack, killing nearly three thousand people. The rubble continued to burn for weeks, filling Lower Manhattan, including Horatio Street, with toxic smoke. OS was in Ithaca, New York, when the attack occurred; he returned to the city a few days later.
To Barnet Koven
A Young Friend
October 15, 2001
2 Horatio St., New York
Dear Barney,
I was delighted to get your letter (of Sept 15)—and yes, thank you, I (and everyone I know) is OK, though many friends have lost friends, colleagues, neighbours etc. in this awful business. I was away—teaching at Cornell, in Ithaca—at the time, and both glad and sorry not to have been right here when it happened. Some people who lived close by and were evacuated from their houses, stayed over in my apartment for a few days.
I went to Ground Zero last night—the pyre is still fuming, and one needs to wear a gas-mask—one cannot realize the scale (and horror) of the thing from photographs alone. Nor the comradeship of the Firemen, Policemen, Sanitation Workers, Salvation Army, Red Cross etc. who are all working (sometimes 16 hours a day) at the site—I spent the whole night talking with them.
I am glad that you, at least, are building, while others are destroying. A solar-powered fan and dog-house (what sort of dog do you have?). Do you know how the sun itself is powered? While you were in British Columbia I was also at high latitudes, on the other side—in Iceland and Greenland, and saw orcas, whales, seals—and one polar bear. It was so beautiful I felt I wanted to spend the rest of my life there.
