Oliver Sacks, Letters,
ed. Kate Edgar, Picador, £30 

THROUGHOUT his life, the great neurologist Oliver Sacks emphasised the human aspect of medical practice. 

Often faced with the most debilitating and apparently dehumanising conditions, Sacks demanded that doctors stopped seeing their patients as “bodies” and instead met them as “human beings”: “We must come down from our position as ‘objective observers’,” he wrote in his famous work Awakenings (1973), “and meet our patients face-to-face; we must meet them in a sympathetic and imaginative encounter.”

This ideal of medical practice runs as a kind of refrain, or perhaps on-going quest, throughout Sacks’s fascinating Selected Letters, brilliantly edited and contextualised by Kate Edgar. Over and over, he rails against the dominant mechanical models of diagnosis, seeking to replace them with something more human. 

In a letter to his father of 1974, he complains that “Medicine has fallen on evil days … The very notion of care has practically vanished, and been replaced by a pedantic passion for new drugs, procedures, methods, techniques.” Similarly, in a letter of 1970, he declares that: “There is something almost inhuman about the mechanical intelligence which has taken over so much scientific and medical writing … and [I] find myself thinking of [it]… as pure Gradgrind.”

In place of a Gradgrind-science based on data, statistics and so on, Sacks seeks to substitute a narrative-based mode of enquiry. Only narrative medicine can facilitate the kind of “sympathetic and imaginative encounter” he wants with patients: “The classical mode of [medical] description is narrative,” he claims, and “I see no way of picturing the innumerable influences and factors involved except in a narrative.”

He envisages “a narrative science, in which the riddle and the tale are one. I suppose this is what one means by … case histories … [which] are studies, and investigations, presented as tales.” In one letter to the neuropsychologist Alexander Luria, Sacks tellingly compares such tales to detective stories, and certainly some of Sacks’s most well-known works, including Awakenings, The Man Who Mistook His Wife for a Hat, Hallucinations and Musicophilia, are structured, in part, like neurological detective stories. 

His letters, too, are often mini-detective stories. He himself admits that he “love[s] letters which deal with investigations and problems” as well as “narrative and narration in letters,” and he loves most of all letters in which these two things are “combined.”

Sacks was a voracious letter-writer, and there are letters here to everyone from family and friends to scientists, philosophers, authors, fans and readers, almost all of them combining, in different ways and to different degrees, both investigation and narration. His letters bear witness to his willingness to meet everyone “in a sympathetic and imaginative encounter,” whoever they are. 

Above all, the reader of Selected Letters meets Sacks himself, face-to-face. It is not just the patient who is humanised “in a sympathetic and imaginative encounter,” but the doctor, too. This is what is at stake in Sacks’s risky yet rewarding mode of medicine: the doctor also has to put their individuality on the line. That is why Sacks’s books are as much about him as they are about the patients he treats. 

These are narratives about both patients and doctor, in which their stories democratically intertwine and sometimes overlap, in what he terms “the proper relation of mutuality.” According to this relation, a doctor should not “tell another person how to be,” or “coerce or cajole another,” but should merely “be himself … quietly embodying … the cardinal qualities of curiosity and courage, of a bold and honest and persistent striving in the face of all difficulties … which assail him.”

In this way, the doctor “can convey some of his qualities to another human being: that is, he can inspire him, entrust him, and — above all — encourage him.” That, I think, also neatly sums up the cumulative effect of the Selected Letters on the reader. 

Jonathan Taylor’s books include the memoirs Take Me Home: Parkinson’s, My Father, Myself (Granta, 2007) and A Physical Education: On Bullying, Discipline & Other Lessons (Goldsmiths, 2024). He directs the MA in creative writing at the University of Leicester.