A Conversation With Oliver Sacks

MS. DIANE REHM

11:06:51
Thanks for joining us. I'm Diane Rehm. As neurologist and author, Dr. Oliver Sacks admits he is agonizingly shy. It's a trait he says that's as difficult for him today at age 80 as it was at 20. But Dr. Sacks has become, as a recent New York magazine put it, the unlikeliest ambassador for brain science.

MS. DIANE REHM

11:07:19
He's published a dozen books including the bestsellers "The Man Who Mistook His Wife for a Hat" and "Awakenings." His most recent book is "Hallucinations," an exploration of the many neurological conditions and situations that can cause them.

MS. DIANE REHM

11:07:42
Oliver Sacks joins me in the studio today. I welcome your questions, comments. Join us on 800-433-8850. Send us your email to drshow@wamu.org. Follow us on Facebook or send us a tweet. And it's so good to see you again, sir.

DR. OLIVER SACKS

11:08:05
Very, very nice to see you again, Diane.

REHM

11:08:07
Thank you very much. You know, I was so interested to see that your father who lived to age 94 said that the 80s were among the most enjoyable decades of his life. My mother-in-law who lived to 92 said exactly the same thing. Why do you think that is?

SACKS

11:08:40
Um, well, some of the urgencies are gone. You have more time. You have more leisure and I think you're just freer. And if you're lucky enough to be in reasonable health, it's a great gift being in the 80s.

REHM

11:08:54
And you are in reasonably good health. You have lost vision in one eye?

SACKS

11:09:06
But the other eye serves me pretty well.

REHM

11:09:10
How did the vision in the one eye get damaged?

SACKS

11:09:13
I developed a tumor, a cancer in that eye at the end of '05 and that was given radiation and lasering, but it spread. It's dormant now, but the vision is gone.

REHM

11:09:34
How did that affect your work or indeed, if you'll forgive me, your outlook?

SACKS

11:09:44
I'd always been passionately fond of stereoscopic vision and stereoscopic photography and had very good 3D vision and probably depended on it too much. Losing that, I find my judgment of space and distance is very difficult and I have to be careful that I say, pour coffee into a cup and I may miss the cup and go on the table.

SACKS

11:10:18
I also don't see to the right of my nose and there's a certain tendency to, and I get no warning, of things coming on the right...

REHM

11:10:28
Oh, I see.

SACKS

11:10:28
...and so I may be startled or I may crash into people. And I've accommodated a little to that, but I thought it would be wise, for example, to stop driving.

REHM

11:10:41
Yes, I can imagine. But now you are due to have a cataract removed from the other eye, which you are totally understandably postponing.

SACKS

11:10:54
Yeah, well, I don't have an eye to spare and though the irreparable side effects are very small, 1 in 5,000 or something, as long as I can get along with the eye I'll postpone surgery.

REHM

11:11:11
You know, I know you have written in previous books about your inability to recognize faces. Do you suppose that that tumor that was growing in the one eye had something to do with that?

SACKS

11:11:33
No, I don't think so. I think the tumor probably only started about eight or ten years ago whereas the difficulty recognizing people has been life-long.

REHM

11:11:44
And was even present for you as a child?

SACKS

11:11:50
Yes, my mother was the 16th of 18 and so there were a great many uncles and aunts and cousins and I had difficulty sometimes distinguishing (word?) and this actually led to an error in my memoir, "Uncle Tungsten" because the picture I printed which was published of Uncle Tungsten was not him.

SACKS

11:12:19
And his family wrote to me, indignantly...

REHM

11:12:21
Oh, my gosh.

SACKS

11:12:21
...and in the paperback, it was changed.

REHM

11:12:25
It was changed and corrected. Well, over the course of your career you've worked with many people who are elderly. What do you think has drawn you to them specifically?

SACKS

11:12:41
Well, it may have been sort of having so many uncles and aunts. I love children and I've often, I've occasionally regretted that I didn't go into pediatrics rather than geriatrics. But I like speaking with people who've had a long experience of life and can tell one stories and who are, one way and another, braving or enjoying old age.

REHM

11:13:16
Braving is a good word, that old saying, growing old is not for sissies, comes to mind. Do you feel that way?

SACKS

11:13:27
I'm afraid I missed that.

REHM

11:13:28
Growing old is not for sissies.

SACKS

11:13:36
Oh, oh, absolutely, no. You have to have more will and more determination and not indulge yourself so much I think.

REHM

11:13:45
Not indulge yourself so much. Dr. Sacks, I believe that you are one of those people who truly indulges himself. But let's talk about "Hallucinations" and tell us what interested you in that topic to begin with, your own experience perhaps.

SACKS

11:14:08
Well, certainly. Well first, all my life I've had a visual form of migraine where you see zigzags and patterns. You may not get any headache and it is all better in 15 or 20 minutes, but that is a very limited form of hallucination.

SACKS

11:14:35
In the 1960s, like many people of my generation, I took all sorts of drugs, LSD and mescal and rightly or wrongly in "Hallucinations," I included a chapter about my own indulgences in that way. But patients with all sorts of problems can have hallucinations, although they're often fearful of acknowledging this to anyone else and sometimes even to themselves. The word hallucination tends to have frightening connotations of losing one's mind.

SACKS

11:15:27
But if people can bring it out, if you can delicately deliver them of this worry and reassure them, it can make a huge amount of difference. In particular, among the old people I see, there are many with poor hearing or poor eyesight, although perfectly preserved intelligence. And something like 10 percent of those with poor vision have hallucinations, sometimes of a kind of elaborate sort.

REHM

11:15:59
Can you describe an example?

SACKS

11:16:02
Well, there was one old lady, for example, in her 90s at a nursing home where I work. It was actually the Little Sisters of the Poor whom I've worked with for 40 years and I love. They said she seemed to be hallucinating. They didn't know what was going on and could I sort things out.

SACKS

11:16:28
And I went into to see this lady. She was very alert. She'd never met me, but she recognized my footsteps and she said that she had been blind, completely blind, for 20 years and now she was seeing things. And I said, what sort of things? And she said that she saw people dressed in green or medieval dress walking away from her at an angle.

SACKS

11:16:56
She also had seen animals of various sorts. She'd seen a snowstorm. She'd seen many people, Lilliputian people, six inches high and she knew these were hallucinations. She'd never had anything like them and she was frightened of their possible meaning.

REHM

11:17:21
She was frightened?

SACKS

11:17:22
I think not so frightened of the hallucinations themselves as to what, as to their possible significance. I went over her carefully. She was very bright. Oh, I said, is this anything like a dream? And she said nothing like a dream. She said it's something like film clips but silent. She said, I see lips move, but I don't hear a sound.

SACKS

11:17:48
Also the hallucinations seemed to be nothing to do with her. They seemed to bear no relation to what she was thinking or feeling or doing. The hallucinatory figures didn't seem to be aware of her, but it was going on by itself.

SACKS

11:18:04
I examined her carefully. She was very bright. I found nothing neurologically the matter. She wasn't on any medication liable to produce medications (sic) but when I looked in her eyes, I saw a sort of devastation, which would go with macular degeneration.

REHM

11:18:22
Hah.

SACKS

11:18:23
I then said to her that this was something which had been described back in the 18th century.

REHM

11:18:36
All right. We'll continue that description by Oliver Sacks in his new book "Hallucinations."

REHM

11:20:01
And just then, during the break as Dr. Sacks and I were sitting here chatting, a group of youngsters from a nearby school dropped by and waved to us from outside the windows of our new studios here on Connecticut Avenue. And of course, Dr. Sacks, you said, once again, it makes me wish I had gone into pediatrics.

SACKS

11:20:31
Yes.

REHM

11:20:32
You really do feel that way, a longing to connect with those children?

SACKS

11:20:38
Yeah, very much so. I've not children of my own, but I have godchildren and a lot of godchildren and nephews and nieces.

REHM

11:20:48
That's great. So you can at least interact with them. To go back to the story you were telling us before the break about the 92-year-old woman. You discovered she had macular degeneration.

SACKS

11:21:06
I said that the sort of hallucinations which were associated with her poor vision, in her case complete blindness, had been described way back in the 18th century by a Swiss naturalist called Charles Bonnet. And they had no significance beyond this and that she needn't be afraid.

REHM

11:21:37
Was she reassured?

SACKS

11:21:39
She was not only reassured but she was rather tickled that her condition had a proper name. She said, tell the nurses that I have Charles Bonnet Syndrome.

REHM

11:21:51
Oh, I love it. Perhaps she even began to enjoy the hallucinations first. You need to describe for us, you need to identify for us what you understand hallucinations to be. What are they?

SACKS

11:22:12
Well, as the old lady brought out, they are not like dreams and also they're not like the products of one's imagination for which one is responsible. They come out of the blue. They startle one. They seem to have a mind or life of their own. And they seem intensely real. They are much more detailed than any images one can form. And they seem intensely real because they are really high jacking the sensory parts of the eye and of the brain. And so the visual parts of the brain through which one normally sees are now preempted for seeing hallucinations.

REHM

11:23:03
Well, then the question would be, if one were under a cat scan or a pet scan and watching the brain as it were undergoing an hallucination, what would you see?

SACKS

11:23:22
Well, this has been looked at in some detail with all sorts of scans, especially with sometimes called functional brain imagery. And you see particular parts of the visual brain if the visual hallucinations light up and become very active. For example, there's a particular part of the visual brain on the right side which is involved in recognizing faces. This is rather poorly developed in people who are not good at recognizing faces but it can become highly active and hyperactive if people are having hallucinations of faces.

SACKS

11:24:01
And you could for example, without questioning them beforehand say, are you seeing faces? If they say, yes I am. How did you guess? It's because the face part of the brain is shooting off by itself.

REHM

11:24:18
Now if you could describe for us in personal terms the differences between drug-induced hallucinations and those that simply occurred in your 92-year-old patient who had macular degeneration.

SACKS

11:24:41
Well, her hallucinations were purely visual. Most drug hallucinations are also visual although there are also some auditory ones. And I had experience of that myself about 50 years ago when I was -- people at the beach where I was -- this was a very drug-oriented culture -- they said, why don't you take this drug? It's called artane.

REHM

11:25:13
A-R-T-A-N-E artane.

SACKS

11:25:15
It was a drug which used to be used for Parkinson's disease.

REHM

11:25:20
I see.

SACKS

11:25:21
And it has some (word?) power. And they said, just take 20 so you'll be in some control.

REHM

11:25:27
Twenty pills, wow.

SACKS

11:25:29
So I took it and at first I noticed no effect. I got a very dry mouth and I couldn't read close up. And I was waiting for something to happen. And while I was waiting I heard a car drive up and a door slam. And a friend of mine and his wife, who often came by on Sunday morning, I said, come in. I said, how would you like your breakfast and I was chatting with them while I was cooking ham and eggs. And then I went out for the tray with their breakfast and there was no one there. And I realized I must have hallucinated the entire conversation.

SACKS

11:26:14
I was a little worried. You know, schizophrenics may hear voices but usually the voices accuse them or make demands of one sort or another. And here we just talked about the weather and ham and eggs. And so that was a pure auditory hallucination and I had no insight into it at the time it was happening.

REHM

11:26:34
And the postscript to that is that you not only ate your own ham and eggs. You ate the other dishes you had prepared.

SACKS

11:26:45
Yes. I had a healthy appetite, which is one of the things I have to watch in my old age.

REHM

11:26:51
Did you wish to experiment with certain drugs to learn about the effects on your brain and your body?

SACKS

11:27:03
Yes, I certainly did. And I wondered what certain exceptional states of mind were like. William James talks about mystical states and he said that for him this only occurred after he had inhaled nitrous oxide, sleeping gas, which I've never done. But I certainly, I think, got some idea through these drug experiences of what my own patients might tell me of their experiences. Perhaps especially the ones who had had experienced something delirious, say with a high fever. And it intrigued me to see how -- and frightened me also to see how drugs could sort of dissect perception, heightened colors specifically or a face color while leaving the rest of the image alone.

REHM

11:28:10
You know, on occasion I've taken a single Tylenol before going to sleep and that has produced the most vivid dreams. Now whether that is some kind of hallucination that's going on as I'm sleeping, how do you differentiate between the two?

SACKS

11:28:38
I haven't heard this described with Tylenol, although I've heard it described with Tramadol.

REHM

11:28:45
Which I've never taken.

SACKS

11:28:46
One tends to have a lot of people and probably everyone occasionally can have very vivid hallucinations of a sort before falling asleep. You don't see these projected outside. They only seem to be on the back of one's eyelids. But there are certainly drugs which can produce very vivid dreaming. And I think some change in dreaming is one of the most delegate ways of judging whether the body is normal or something is happening.

REHM

11:29:29
That's interesting. Help me understand that a little better.

SACKS

11:29:34
Well, the Tylenol is -- I've never heard of anyone describe any side effects for Tylenol but with you it was dreams which changed. When I was working with Parkinsonian (sp?) patients and they were put on L-DOPA or Sinemet, often the very first thing they would say was that dreams had become more vivid and sometimes more charged with emotion. And the -- I think just sleep dreaming is a very, very sensitive system and it's easily disturbed one way or another.

SACKS

11:30:18
And it changes according to one's interests. I know when I was writing about my early years and my passion for chemistry, I would have dreams about chemistry every night.

REHM

11:30:34
But do you think that the L-DOPA and its effects on the brain perhaps had induced hallucinations in people with Parkinson's?

SACKS

11:30:51
Well, I think this can certainly happen. How often it happens and how much it matters is another question.

REHM

11:31:02
When you say how much it matters if, for example, a person with Parkinson's acts out on those hallucinations, that would be another step.

SACKS

11:31:17
Yes. I have one patient who broke a hip after chasing a hallucinatory mouse. And among other things I said to him, let the nice be. Don't go after them.

REHM

11:31:33
Just leave the mice alone.

SACKS

11:31:36
Yes.

REHM

11:31:37
What is it that so intrigues you about the relationship between religion and hallucination?

SACKS

11:31:48
Well, many people have religious visions or voices. The word hallucination was only given its present connotation about 200 years ago. And it sounds rather too medical. But -- so if one just talks about visions or voices, well, these tend to be visions or voices of a very unusual sort which almost command belief or obedience. I think it's not easy to be skeptical with regard to one's own visions. Although one may have to be.

SACKS

11:32:40
Joan of Arc who had visual and auditory hallucinations always to one side was at first fairly skeptical and was only gradually converted to an idea that these must be of divine origin. In her case, by the way, it seems very likely that she had a form of epilepsy, so called temporal lobe epilepsy. This doesn't in the least alter the value or otherwise of her visions or hallucinations or beliefs. This is only a natural basis.

SACKS

11:33:23
One knows that Dostoyevsky had seizures and sometimes in the beginning of seizures he would suddenly say, God exists. And he would talk about an ecstasy so great that he would give his entire life to have this, a feeling of joy and union and understanding. And I think that whenever there is an acute conversion to religion rather than just going to church or synagogue in the customary way, an acute -- as William James says, if religion presents as an acute fever than there's usually some very unusual sensation.

REHM

11:34:11
Oliver Sacks. We're talking about his new book "Hallucinations." And you're listening to "The Diane Rehm Show." We've got many callers. We want to open the phones now, 800-433-8850. First to Tim in Hanover, Pa. You're on the air.

TIM

11:34:39
Thank you, Diane. And thank you, Oliver Sacks, for your inspirational writing. I've been in the mental health field for coming up on 30 years now. And certainly, you know, see your writing as to be up there with Marcel Proust. Your writing and your inspiration is just really, really fascinating to me. And I extrapolate your writings to look at just the plasticity of the brain and the hope for us as humanity to better understand where we are. So I thank you for that.

SACKS

11:35:16
Well, thank you.

REHM

11:35:18
I'm glad you called, Tim. Thank you for that. Let's go on to Mary in Culver, Ind. Hi, there.

MARY

11:35:29
Hi. Thank you so much for taking my call and...

REHM

11:35:32
Sure.

MARY

11:35:32
...thank you, Dr. Sacks, for your work. I'm a music educator and I'm also a musician -- performing musician. And I was listening earlier when you were talking about having wished that you had gone into pediatrics in a way. I wanted to let you know that at the school where I teach, a wonderful relationship has developed between the music department and the wellness department. And I present to classes on music and the brain. And we use so many resources from your research.

MARY

11:36:03
We've looked at some of the videos from Alive Inside, the iPod project where the brain responds to music and memories come back. And we've looked at the Music Therapy Institute out of Nordoph (sp?) . And just so excited about the possibilities. And the students get so excited and everyone is moved when they see these films and learn of your work. So thank you.

SACKS

11:36:29
Well, music can play an enormously important part with all sorts of disorders. I actually first saw this with my awakings patients back in the '60s, people who could often hardly speak or move but were able to sing or dance. And music and rhythm would get them moving in a way which nothing else could. And -- but music can also be very important for people who have lost the use of language or aphasic because they may discover or you may help them to discover that they can sing. And in singing get the words of the song as well. And this is very reassuring because it shows them that language is there even if embedded.

REHM

11:37:18
Oliver Sacks. And if you'd like to join us, 800-433-8850. His new book, a National Bestseller is title "Hallucinations."

REHM

11:40:02
And welcome back. Oliver Sacks is here with me. You know him as one of the foremost writers and physicians with knowledge of the brain. His newest is a book titled, "Hallucinations." Let's go back to the phones and to Robert in Winston-Salem, you're on the air.

ROBERT

11:40:31
Yes, Diane and Dr. Oliver Sacks. I'm really enjoying this show. I guess I had a comment that I hoped to get a response to. You had mentioned earlier, Diane, about the relationship between spirituality and hallucinations, I guess.

REHM

11:40:46
Yes.

ROBERT

11:40:47
A number of years I've been involved, both professionally, in the legal field, but also at times with contact with people who had had hallucinations or who had mental instability. I've also been involved for many years in the practice of yoga and meditation. And also have read a number of books on hallucinations. And one of the things I found interesting is that if you go to the yoga sutra, the original yoga sutras are based upon a foundation upon a substance, what's called soma, which was a hallucinogenic drug, evidently used to induce a meditative state.

ROBERT

11:41:29
And what Patanjali eventually came to the conclusion was that you did not need the soma substance. That you could go into this same kind of state through a meditation. And my own experience, years of doing meditation on a daily basis, by myself usually, is that often things come and arise in front of me. I see hallucinations all the time. It just seems to me that part of the nature of the human mind is that we do hallucinate. And the other aspect with people I've come in contact with no instability is that one of the assumptions I'm -- this is what I'm sort of getting with Dr. Sacks about is that one of the things I've come to conclusion is that we make a basic assumption, which I think we have to do in reality, is that we assume that our senses and our sensory perceptions are real and correct.

ROBERT

11:42:17
But in fact we have no direct way to confirm that completely.

SACKS

11:42:20
Yes.

ROBERT

11:42:20
And in a sense, everything we experience could be considered to be a possibility of being an illusion.

REHM

11:42:26
All right.

SACKS

11:42:27
And that's one of the insights of yoga, is that maybe all of assumptions, including the ones we have to live with, that in some sense, everything we deal with is based upon…

REHM

11:42:39
All right. I’m going to stop you right there. Go right ahead, Dr. Sacks.

SACKS

11:42:42
Well, certainly every culture has discovered substances with hallucinogenic power. And I guess soma was one of them. But certainly you're right that meditation alone can get one into unusual states of mind and so, as evangelistic people maintain, can prayer, intense prayer, which may involve conjuring up visual images, say exactly what did Jesus look like, which direction was he facing, how was he dressed. And after awhile there may be a leap from extremely vivid imagery to hallucination. And this may -- since hallucination seems to be autonomous and to come from outside, this may have a power of enforcing belief or persuading people, which imagery doesn't.

SACKS

11:43:51
But I agree that we tend to assume that what we see and hear is real. And with regard to religion, there was, for example, a recent book called, "Proof of Heaven," in which the author describes a very elaborate near-death hallucination, so-called. He feels he went to heaven and all that. And he now believes, whereas a hallucination can only indicate that something is going on in the brain. It cannot indicate that something is out there.

REHM

11:44:39
I see. I see. I want to ask you about what I'm going to call an epidemic of problems relating to Parkinson's, relating to Alzheimer's, relating to dementia. I am beginning to wonder whether rather than delineating them into separate fields, whether we might make more progress discovering causes and treatments, if in fact, we grouped them together.

SACKS

11:45:24
Well, this is a very, very important point and it's very much a subject of debate now, and in particular since the late 1980s there has been a new notion coming in that all of these diseases may finally be due to what are called prions in the brain. And a prion is a protein which has become deformed and which then imposes its own wrong shape on the other proteins in the brain. And it may be that Alzheimer's and Parkinson's and a dozen other diseases, which may not have common names, are ultimately prion diseases. And the thought is that this could be treatable or preventable if diagnosed sufficiently early. It's thought that, for example, Alzheimer's may be present 20 years before a person has any symptoms, but there may be ways of finding who is at risk from any of these diseases and getting to work to prevent them getting it.

REHM

11:46:44
And you're, I presume, indicating that blood test might indicate whether these prions are present in the brain or would it have to be through watching the brain at work?

SACKS

11:47:09
It's conceivable that the blood or other tissue might have this, but what seems to be the most sensitive at the moment are certain forms of brain scan, which can show abnormal substances in the brain very early, before they have disturbed it at all.

REHM

11:47:26
Now, Huntington's is one of those where an individual can know years in advance whether one is going to develop the disease?

SACKS

11:47:42
Whether they want to know with something like Huntington's, one knows that one may have a 50/50 chance. If you get further information you may find your chances are either 100 percent of 0 percent.

REHM

11:47:59
Wow.

SACKS

11:48:00
And this is a very individual matter.

REHM

11:48:02
As to whether one wishes to know. I can certainly understand that. All right. Let's go to O'Fallon, Mo. Hello there, Elli.

ELLI

11:48:17
Hello. Good morning, Diane. And, Dr. Sacks, I just have to say I so enjoy hearing all these interviews with you that I hear and thank you. I have had in my life what I consider auditory hallucinations. And I am wondering if they are -- I've also been a lifelong sufferer of migraines. And I'm wondering if those are connected.

SACKS

11:48:41
What are your auditory hallucinations like?

REHM

11:48:44
Oh, I’m afraid she's no longer with us, but…

SACKS

11:48:48
Okay. Well, I’m not sure what sort of auditory hallucinations. A big census was done in the 1890s, where 17,000 people answered, and it was evident that about 10 percent of the population have auditory hallucinations. One of the commonest is hearing one's name spoken. These are hallucinations. They're not like schizophrenic ones. They're not addressed to one. They're not messages. And one could have them in migraine, although this would be very unusual. Freud himself describes having auditory hallucinations on two occasions. Once when he was a student in Paris and pining for his fiance back in Vienna. He would hear his voice called by a familiar and beloved voice.

SACKS

11:49:47
He was always slightly spooked by this and would wonder if anything had happened in Vienna, but he would never find any correlation, although he later wrote a paper on telepathy and psychoanalysis. On another occasion, when he was in great danger of his life, he heard a voice, as he says, shouting in his ear saying this is the end. And in front of his eyes a sort of placard with those words written on it. And…

REHM

11:50:18
Well, and you, yourself, were in danger at one point, descending a mountain with a badly injured leg. What did you hear?

SACKS

11:50:31
Well, at one point I was getting very exhausted and I thought it would be nice to stop and have a rest or a nap. And a very clear voice said, no, you mustn't do that. That's death. You know, keep going, find a pace, you can keep going and keep going. And I've also heard of people about to commit suicide who are stopped by hearing a voice. So there could be good voices, as well.

REHM

11:51:04
And, of course, we remember in the novel, "Jane Eyre," that she hears Mr. Rochester calling her at the very end of that book. Let's go now to, I think, Bluffton, Ind. Curtis, you're on the air.

CURTIS

11:51:28
Good morning. I have enjoyed listening to you on the radio for many years. And Oliver Sacks' work, a little bit I'm acquainted with, but I was fascinated with what you were talking about today. I’m an ex-drug user and an ex-convict. I quit using drugs back in the early '70s. I had a spiritual experience. And I fell in with a group of people that were Pentecostal. And I received -- I had an experience called the baptism of the Holy Spirit. And that was -- and I loved LSD. Okay. I really enjoyed the hallucinations I had with LSD.

CURTIS

11:52:12
And I've had some physical experiences with ladies that were wonderful experiences, but feeling this strange thing called the baptism of the Holy Spirit, which I believe is God's presence, is by far the most wonderful experience I've ever had in my life. And it still happens to me occasionally.

REHM

11:52:36
Dr. Sacks, do you want to comment?

SACKS

11:52:39
Well, I'll say good for you.

CURTIS

11:52:41
Yeah, thank you.

SACKS

11:52:41
And, no, certainly by accounts there is nothing to match religious experiences of this order. And something like LSD may just be a step on the way and later you can dispense with it. But I'll just say good for you. I, alas, am one of the unbelievers.

REHM

11:53:03
And you're listening to "The Diane Rehm Show." So despite the experiences you've had, both drug-induced and otherwise, you do not have any strong religious belief?

SACKS

11:53:20
No, I don't. And I have never had. On the other hand, I have a strong passion for the here and now and the wonder of nature and that's enough for me.

REHM

11:53:30
What about shyness, Dr. Sacks, is there or have you ever experimented with some kind of drug to help you through that?

SACKS

11:53:44
Well, there's a drug or substance called oxytocin, which is produced by the body, which is said to increase feelings of sociability and friendship and to help people open out. I've never tried it. I would quite like to if it's safe to do so. My shyness disappears if I'm engaged in talking about medicine or science. I remember once there was an eclipse of the moon and I went outside with a telescope. And I was stopping people in the street saying, look, look.

REHM

11:54:18
Look.

SACKS

11:54:19
And I was almost like an evangelist then. But I think there's some biological basis for this. One finds, not only in human beings, some animals which are relatively withdrawn and others which…

REHM

11:54:36
Yes.

SACKS

11:54:36
…outgoing. And although I called it excruciating, it has its advantages, too.

REHM

11:54:45
Such as?

SACKS

11:54:45
Such as you can be by yourself and your reticence is respected. And I think you're not continually overinvolved in social life.

REHM

11:54:59
Tell me how you spend your days these days, now that you've turned 80?

SACKS

11:55:09
Well, my day usually starts with a swim. And this happened today. There was a very nice pool in the hotel. I still see a few patients, but otherwise much of my day is spent reading and writing. I do all my writing with a fountain pen. I love the feeling of ink and paper. I have several fountain pens filled because I don't want to run out of ink in the middle of a thought.

REHM

11:55:43
Or the middle of a word.

SACKS

11:55:45
Or word, yes. And in the evening I will usually have dinner with an old friend or sometimes go to a concert. I'm a little deaf now, which affects the understanding of speech and increases shyness, but music doesn't seem to change. And music is very important in my life.

REHM

11:56:07
Do you sleep at all during the day?

SACKS

11:56:12
I did actually fall asleep briefly in the car which brought me here. I, in general, no, but sometimes I do.

REHM

11:56:23
But you continue your pace of writing pretty much every day?

SACKS

11:56:32
Yes. I don't know. Occasionally I come to a sort of halt with major writing, but then I write letters. I love receiving and writing letters.

REHM

11:56:45
Beautiful. Dr. Oliver Sacks. His new national bestseller is now out in paperback. It's titled, "Hallucinations." What a pleasure to talk with you again.

SACKS

11:57:00
My pleasure, too.

REHM

11:57:02
Thank you. And thanks for listening all. I'm Diane Rehm.
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