September 07, 2019

If the brain is to stay healthy, it must remain active, wondering, playing, exploring, and experimenting right to the end.

© Bill Hayes / Oliver Sacks Foundation

Everything In Its Place: First Loves and Last Tales
By Oliver Sacks

Admired Oliver Sacks' compassion towards his patients and his devotion to science, especially neurology. He also had such vast curiosity and enthusiasm about life. From his love of swimming, reading, and nature, to his descriptions of awe-filled, strange, lovely experiences including attending an annual herring festival in NYC, meeting an orangutan for the first time, and more—I loved reading about his adventures and perspectives. He lived life openly, intelligently, fully.

"Mr. Q was another patient, less demented than Dr. M., who resided in a nursing home run by the Little Sisters of the Poor where I often worked. He had been employed for many years as the janitor at a boarding school and now found himself in a somewhat similar place: an institutional building with institutional furniture and a great many people coming and going, especially in the daytime, some in authority, and dressed accordingly, others under their guidance; there was also a strict curriculum, with fixed mealtimes and fixed times for getting up and going to bed. So perhaps it was not entirely unexpected that Mr. Q should imagine that he was still a janitor, still at a school (albeit a school that had undergone some puzzling changes). But if the pupils were sometimes bedridden or elderly, and the staff wore the white habits of a religious order, these were mere details—he never bothered with administrative matters.
He had his job: checking the windows and doors to make sure they were securely locked at night, inspecting the laundry and boiler room to make sure all was functioning smoothly. The sisters who ran the home, though perceiving his confusion and delusion, respected and even reinforced the identity of this somewhat demented resident, who, they felt, might fall apart if it were taken away. So they encouraged him in his janitorial role, giving him keys to certain closets and encouraging him to lock up at night before he retired. He wore a bunch of keys jangling at his waist—the insignia of his office, his official identity. He would check the kitchen to make sure all of the gas rings and stoves were turned off and no perishable food had been left unrefrigerated. And though he slowly became more and more demented over the years, he seemed to be organized and held together in a remarkable way by his role, the varied tasks of checking, cleaning, and maintenance that he performed throughout the day. When Mr. Q died of a sudden heart attack, he did so without perhaps ever realizing that he had been anything but a janitor with a lifetime of loyal work behind him.
Should we have told Mr. Q that he was no longer a janitor but a declining and demented patient in a nursing home? Should we have taken away his accustomed and well-rehearsed identity and replaced it with a "reality" that, though real to us, would have been meaningless to him? It seemed not only pointless but cruel to do so—and might well have hastened his decline."
("Telling," pp. 142-3)

"If the brain is to stay healthy, it must remain active, wondering, playing, exploring, and experimenting right to the end. Such activities or dispositions may not show up on a functional brain imaging or, for that matter, on neuropsychological tests, but they are of the essence in defining the health of the brain and in allowing its development throughout life."
("The Aging Brain," pp. 153)

"The two preeminent evolutionary changes in the early history of life on Earth—from prokaryote to eukaryote, from anaerobe to aerobe—took the better part of two billion years. And then another thousand million years had to pass before life rose above the microscopic and the first multicellular organisms appeared. So if the Earth's history is anything to go by, one should not expect to find any higher life on a planet that is still young. Even if life has appeared and all goes well, it could take billions of years for evolutionary processes to move it along to the multicellular stage."
("Anybody Out There?," pp. 206-7)

"For myself, since I cannot wait, I turn to science fiction on occasion—and, not least, back to my favorite Wells. Although it was written a hundred years ago, "A Lunar Morning"* has the freshness of a new dawn, and it remains for me, as when I first read it, the most poetic evocation of how it may be when, finally, we encounter alien life."
("Anybody Out There?," p. 210)

"Reading is a hugely complex task, one that calls upon many parts of the brain, but it is not a skill humans have acquired through evolution (unlike speech, which is largely hardwired). Reading is a relatively recent development, arising perhaps five thousand years ago, and it depends on a tiny area of the brain's visual cortex. What we now call the visual word form area is part of a cortical region near the back of the left side of the brain that evolved to recognize basic shapes in nature but can be redeployed for the recognition of letters or words. This elementary shape or letter recognition is only the first step.
From this visual word form area, two-way connections must be made to many other parts of the brain, including those responsible for grammar, memories, association, and feelings, so that letters and words acquire their particular meanings for us. We each form unique neural pathways associated with reading, and we each bring to the act of reading a unique combination not only of memory and experience, but of sensory modalities, too. Some people may "hear" the sounds of the words as they read (I do, but only if I am reading for pleasure, not when I am reading for information); others may visualize them, consciously or not. Some may be acutely aware of the acoustic rhythms or emphases of a sentence; others are more aware of its look or its shape."
("Reading the Fine Print," pp. 230-1)

*"Imagine it; Imagine that dawn!"
-From H.G. Wells' The First Men in the Moon, chapter 8, A Lunar Morning

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