Oliver Sacks put himself into his case studies – what was the cost?
newyorker.com41 points by barry-cotter 12 hours ago
41 points by barry-cotter 12 hours ago
https://archive.ph/0MFPK
This was a nice profile of (one side of) Sacks and his life, and as usual some mischievous or click-seeking online editor has given it a headline (and sub-heading) that are almost completely unrelated to what the article is about. In fact, at the bottom it says: > Published in the print edition of the December 15, 2025, issue, with the headline “Mind Over Matter.” and a headline like that (saying nothing) would be more appropriate to this. The very fact that Sacks wrote about his patients has always had its detractors—based on his book The Man Who Mistook His Wife for a Hat, someone called him “the man who mistook his patients for a literary career”—but what was surprising (to me) from this article is that it seems that after that early book, he actually became careful not to exaggerate or make up stories, to the extent that someone closely following him looking for discrepancies was not able to find any. I would have expected the stories to be mostly fictional, but it appears that this is so only of his early books. I assumed the books were somewhat fictional (i.e. they were Gladwell-style) because if he meant to make a claim seriously he'd have published in a medical journal instead of a popular/literary book. But since writing the comment above, I've learned that over the years many people actually believed that all details in the books were literally true (you can search for e.g. [Sacks prime] to see many people who took the story seriously and analyzed them), which does put things in a different light. if I search for Sacks prime, I get articles about Ulam spiral what exactly was I supposed to find and see people believe? I’ll do you one better, I believed Gladwell wasn’t writing fiction either. Not OP but I guess Gladwell-style can be understood as writing that is presented as nonfictional but has more in common with fictional writing. I disregarded everything from him after I read two of his books. It’s not perfect, but my rule of thumb is simple: If a scientific story feels sexy, cinematic, and narratively perfect, it’s likely fabrication. Same reason I have been skeptical towards dark energy, EMDR, and the blue light destroys sleep craze. And many other stupid stuff. If you like a story or a finding, that’s a clue to double the critical sceptisism. I'd always assumed that the patients in Sacks' books were lightly fictionalized composites that combined interesting features from multiple cases. The purpose being to illustrate conditions and aspects of human psychology for a general readership. Since they weren't presented as rigorous case studies, I didn't take them to be that. I find what Sacks did much less irksome than more recent psychological and social studies books that pretend to be presenting rigorous scientific fact when they are, in fact, tendentious bullshit. I actually set that book down while reading it and said, “this sounds made up.” Ahh the quiet satisfaction of witnessless vindication. Yeah the thing about the twins calling out 20 digit prime numbers did it for me. Even allowing for the twins having some ridiculous magical ability to think up such primes, Sacks iirc claimed to confirm the numbers' primality by looking them up in a table of primes. Nuh uh. Added: ok, found a more careful description. https://www.pepijnvanerp.nl/articles/oliver-sackss-twins-and... While I also doubt the twins ability to calculate unknown primes, I do think that the article falls prey to many of the same trappings that they are calling out Oliver Sacks for. While Oliver didn't know math enough to talk about known prime number tricks, the author of the article also clearly didn't know books well enough to include ruling that aspect of the story as false since a commenter found at least a contender for the book, which also opens up the theory that the twins memorized the numbers from a book. To take it a step into theorizing, since it's been shown at least one book existed, maybe others that have been lost to age also existed. Also, with no proof the article talks about how the twins perceived the numbers, saying "More likely is that they called out the numbers figure by figure" instead of in the extended format. A 25 digit number is only in the septillion area, and numbers follow a latin naming scheme so it's not even that hard to remember. This is comparable to Oliver assuming further numbers were prime with no proof. Plus there's the fact that this is all in hindsight, I think it'll be fun to look back in 40 years from now and see how the article stands the test of time. Maybe we discover an easy way to calculate arbitrary primes in our head and the original story becomes believable. In case this piqued your interest, I really enjoyed the documentary about his life's journey, https://en.wikipedia.org/wiki/Oliver_Sacks%3A_His_Own_Life - can recommend! (Also, fan of his books and research.) I second the documentary. Also a very notable statistic/anecdote at the end. I don't know how wide the scope (only one university?), but about a third of the incoming neurology students chose the field because of Oliver Sacks. I always found the bulk of the criticism leveled against him to be faulty. However, if he did indeed fabricate a lot of details - it is concerning. (I wanted to put https://news.ycombinator.com/item?id=46204853 in the second chance pool* but it was too old, so I spawned a new copy of the submission and moved the (relevant) comments hither. I hope that's ok as a technical workaround... * explained at https://news.ycombinator.com/item?id=26998308) > When [Sacks] woke up in the middle of the night with an erection, he would cool his penis by putting it in orange jello. This is a remarkable sentence, and it appears suddenly in the article without context or explanation. Naturally, there are questions. Was it necessarily orange jello? Does orange refer to the flavor or the color? What property of this particular jello made it preferable to other flavors and colors of jello? Did he prepare the jello for this particular purpose, or did he have other uses for the orange jello? What were they? Did he reuse jello or discard it after one use? Most important though: why would he do this?? The article does not say. orange the color is a reference to orange the fruit. prior to the fruit coming to europe, that color did not have it's own name https://www.atlasobscura.com/articles/orange-fruit-color-ori... It says why in the quote, to “cool” it. I have never tried it myself but it seems like it would be effective for that purpose. your comment in the context of jello makes me think of Cool Whip, but that takes us to "You must whip it: Whip it good!" and here we are full circle. It is a great article. It is. I might sound critical, but my criticism is not of the article. Nor of Sacks and his jello, really. I rather liked Private Eye’s spoof Sacks book title many years ago: “The Man Who Mistook his Patients for a Publishing Opportunity” Loved Oliver Sacks. He was such a kid at heart with a big brain and soft demeanor. His interviews are great. Here is one https://www.youtube.com/watch?v=4AnuxDdg2II It is rare a lisp can improve how one sounds, but I like his. Another book I was recently sad to learn was at fabricated is The Salt Path, which was great but apparently based on lies, the author was fleeing debt and lawsuits and stole $86,000 from their previous employer prior the walk. What is super sad is they didn't pay the people back they stole money from after their book became a best seller: https://observer.co.uk/news/national/article/the-real-salt-p... It's also became a movie staring Gillian Anderson and Jason Isaacs. Or more recently Dan Kahneman, Dan Arielly or Stephen Jay Gould have also been caught fabricating details or whole results. The Fifty Minute Hour / The Jet Propelled Couch would be a classic example. Lindner's 'patients' were composite characters. I don't know of any thimble recent (or non-recent) where Gould was "caught fabricating details or whole results". In 1981 Gould accused Morton of fabricating details. Gould died 20 years after that. Nine years after Gould died, some said Morton had not fabricated details. I should add Morton was a phrenologist who did not believe in common descent. > Dan Kahneman I know the underpowered studies cited in Thinking Fast and Slow didn't replicate but I don't think there was any fabrication? The famously ironic case of honesty in a study about honesty https://retractionwatch.com/2021/09/14/highly-criticized-pap... That's Dan Ariely. I don't think there's any known example of Kahnemann fabricating data. As fair as I know none of the research by Kahemann himself is suspect, but a lot of the studies he cited in Thinking Fast and Slow, especially the ones about priming, have failed to replicate. YMMV on what this implies for the book as a whole. He's open about the priming chapter concern: https://retractionwatch.com/2017/02/20/placed-much-faith-und... I feel that his pretentious, overwrought and unctuous writing was perhaps all because of an emptiness or inadequacy… His final years as a nice old gay man seem much more _normal_ and real, and he seems less of a fantasist at that stage… Not shocked. "Science" of the 1900s was heavily influenced by people willing to do whatever it took to achieve fame or fortune. The replication crisis is the result. Humans are not magically better now just because the calendar reads 2025 instead of 1900. Much of what academics do today is not science either. Journals are filled with supposedly scientific publications, but actually producing new scientific knowledge is really difficult and rare. There's a lot of garbage in there. I don't think it was just the 1990s. A lot of science really wasn't very rigorous in the 1960s through the 1980s either. > "Science" of the 1900s was heavily influenced by people willing to do whatever it took to achieve fame or fortune. Scientific research of the 1900s made incredible improvements in medicine and technology. Most of the researchers and scientists weren't trying to be famous or extraordinarily wealthy. The people you see pursuing fame and fortune, writing books, doing podcast tours, and all of the other fame and fortune tricks are a very small minority. Yes, people in that minority have often been discovered as writing stories that sound good to readers instead of the much more boring truth. However, most people doing science and research aren't even operating in this world of selling stories, books, and narratives to the general public. Typecasting all of "science" based on the few people you see chasing fame and fortune would be a mistake Sacks wrote from 1970 through to 2015; so more recent than just the fusty old 1900s… I'm not sure the Quantum Theory revolution as well as the nuclear revolution can be called "science" (ironically using the quotes) The Solvay Conference happened in 1927 > "Science" of the 1900s Science of any kind, looked at dispassionately, is more of a cult than we're prepared to admit. Not a discussion we're going to have any time soon, not until the miracles run out. Could you leave us some hints about what you are alluding to ? Or even better, clearly and honestly spell out what you actually think? I can’t speak for the author, but I attended a science conference earlier this year that was almost half science, half healing/meditation workshops. I’m not going to name names, but there were some
pretty big academic names there who also have clearly woken up to modern science being more than a bit cult like. Research a couple of areas of science that are currently verboten and see who & what you find there maybe? It’s just quiet whispers in small conferences at the moment, but this is how the breaking of all spells begins. The momentum is & will continue to build, and probably quicker than many imagine (or will like!). I've been a professional scientist for more than 30 years, and have no experiences like this at all. A scientist names names. Not doing so is innuendo, and prevents any verification. Would you mind naming the exact field or the topic of the conference? Because of course "science" is a term that's been quite often usurped by all kind of snake oil sellers, but that's nothing new is it? Steven Pinker on this article: >https://x.com/sapinker/status/1999297395478106310 >"Bombshell: Oliver Sacks (a humane man & a fine essayist) made up many of the details in his famous case studies, deluding neuroscientists, psychologists, & general readers for decades. The man who mistook his wife for a hat? The autistic twins who generated multi-digit prime numbers? The institutionalized, paralyzed man who tapped out allusions to Rilke? Made up to embellish the stories. Probably also: the aphasic patients who detected lies better than neurologically intact people, including Ronald Reagan's insincerity." Subtitle > The scientist was famous for linking healing with storytelling. Sometimes that meant reshaping patients’ reality. TLDR > after her grandmother’s death...she becomes decisive, joining a theatre group.... in the transcripts... [she] never joins a theatre group or emerges from her despair. AFAICT the quote above is the only thing directly relevant to the title. From what I read, skimming through the article, it paints Sacks as being a delusion driven emotional romantic and was practicing some sort of cult medicine, but I can't tell how much of that is reality and how much is NYT's ridiculously flowery embellishing of everything. I agree that its a hard read, and seemingly never got to the point of the title of the article. I started reading it and by about the eighth or nineth paragraph the article was still ruminating on his gay love affair so I just skimmed the rest and I couldn't make heads or tails of the rest of it either. Its shocking how bad some writers are these days. If you go further, the whole thing wraps around. His suppression of his own sexuality, led him to embellish, to write out his own internal dialogue into the "nonfiction" books he wrote. So it all eventually comes back to the thesis, but yes, it's a huge drag to read through, but then Sacks' own writing is so turgid and overly dramatic, like he was writing for an audience. The first sentence too is apt, "butter colored suit that reminded him of the sun" is a great example of Sacks' writing style. I love when the new yorker gets posted to HN because of how many people will proudly announce themselves not equal to the challenge of a mainstream middlebrow magazine article. That description (mainstream middlebrow) would have been accurate in 1980. I don't think it is anymore. Long form journalism is not a common thing anymore, men (who dominate HN) are not enthusiastic readers anymore, and the cultural conversation that a dead-tree magazine represents is no longer amplified in mass media (as opposed to an era when David Frost and Dick Cavett had primetime shows on TV). I don't disagree about the reverse snobbery, but IMO people being "not equal to the challenge" isn't the actual problem. I love most of their stuff and the writing is pretty eloquent as it takes you on a journey that's easy to follow and flows easily from one paragraph to another. This was just a slog that I felt went nowhere and the points were buried in between rambling information about Sacks and his gay lifestyle, lovers and living in NYC and the gay lifestyle there at the time. Not only was it not interesting, it was poorly written and hard to read. Sometimes writers just need to stick to the facts instead of trying to write another "The Phenomenology of Spirit" for a "middlebrow magazine". This was sticking to the facts - this is original research into Sacks’ letters and unpublished writing. It’s for readers who read Sacks in the New Yorker and want to see another side of his life. I read four other articles in this week's New Yorker by the time I got to this one and the problem it has is we are probably at this point all familiar with the story of a gay person coming to accept themselves and there was nothing new in this version for a very long time so when it belabors the point there is a real danger to losing the audience, I read the magazine just prior to bed and gave up on this one after first attempt, enjoyed the rest of the magazine (even some of the culture articles about New York residents) and came back to this article and fell asleep. I don't think it's as revealing as you suggest. Writers write, and editors edit, for an audience. HN is definitely not a perfect match for the New Yorker's intended audience. But most readers of the New Yorker would choke on the kind of stuff that is perfectly aligned with HN's readership, so... Exactly. It's the equivalent of those people on Reddit or social media in general who make fun of three-star Michelin restaurants. I get that sometimes you just want McDonald's, and I don't think there is a definition of better and worse in either of these contexts that doesn't require injecting some kind of taste. But nonetheless. In a few decades reading will be a lost art. Yes the stats are really that worrying. If anything is shocking it is how modern readers have to be spoon fed bullet points and can't handle the slightest complexity of composition. It might be that modern readers have other things they can read/do with their time. In pre internet times it wasn't so much the case - you'd buy a mag or book and then read it but now there are many alternatives a click away. Pros and cons but often in the old days it was spun out to fill some volume the the printing press was set for like 400 pages in a book. I did Great Expectations at school which had about ten chapters with the main story and then about 60 chapters of irrelevant stuff because Dickens was paid weekly by the chapter. Respectfully, I'm not sure you can draw meaningful conclusions about a 100+ paragraph deep-dive article after reading the first eight or nine. The biography stuff is definitely relevant to the takeaways about Sacks' methodology and style: > Other doctors had dismissed these patients as hopeless, but Sacks had sensed that they still had life in them—a recognition that he understood was possible because he, too, felt as if he were “buried alive.” [...] > Another patient is so aroused and euphoric that she tells Sacks [according to his telling in Awakenings], “My blood is champagne”—the phrase Sacks used to describe himself when he was in love with Vincze. [...] > “I know, in a way, you don’t feel like living,” Sacks tells her, in another recorded session. “Part of one feels dead inside, I know, I know that. . . . One feels that one wants to die, one wants to end it, and what’s the use of going on?” > “I don’t mean it in that way,” she responds. > “I know, but you do, partly,” Sacks tells her. “I know you have been lonely all your life.” The New Yorker's primary editorial thrust has always been that the author is more important than the subject, and the journey is more important than having a thesis at all. Speaking of suboptimal writing, why call it a 'gay' love affair, when he was openly gay? One of the most important details of Sacks's life which dogged him nearly to the end (and which is important to this NY piece), was a minimization by Sacks of his own sexuality. He was not "openly gay" at all. Just a nit but it's the New Yorker, not the NYT. Also worth noting that the New Yorker published a lot of essays from Sacks when he was alive. So there's a sort of meta thing happening here with a biography of one of their famous contributors. Yeah he was the consummate neurotic New Yorker writing for the New Yorker and now in death he has been woven directly into the New Yorker. A responsible journalist can't say directly that Sacks was a confabulist but they can point out facts and allow the reader to infer. That's what the article does. There are many facts in the article that are relevant to the title in this sense (the prime number twins, the journal entries about Hat, etc.). I also don't agree with your interpretation of what the article is trying to paint Sacks as, though of course you are entitled to it. I think the the point of the article is to articulate what Sacks himself said: > "As Sacks aged, he felt as if he were gazing at people from the outside. But he also noticed a new kind of affection for humans—“homo sap.” “They’re quite complex (little) creatures (I say to myself),” he wrote in his journal. “They suffer, authentically, a good deal. Gifted, too. Brave, resourceful, challenging.”" Haven’t read the article yet, but I love the respect with which you pointed out your differences to GP. thank you. As a general rule, neurologists are an odd bunch. I'm married to one; I've met lots of them at her conferences. The stereotype, which is sometimes true, is that people do that kind of degree because they want to understand and solve their own issues. Those who are are interested in people as such, can be more drawn to anthropology. More true of psychiatry than neurology, though there is of course some overlap. The running joke in neurology is that neurologists are left-handed migraneurs/euses. I was once at a small dinner talk by a well-respected headache specialist, surrounded by a dozen neurologists. He asked, "How many here have chronic headaches?" Every hand went up except mine and the drug rep's. I think the title doesn't really give a good impression of the contents of the article. The article spends most time on evolution Sacks' homosexual identity and struggle with sexuality and repression. His uncertainty and melancholical bouts maar him question his own work and make the author conclude him 'putting himself in his work'. However very little evidence is presented. Most insinuated about is 'awakenings' yet even in that case it's hard to reach conclusions. The author plays of his perennial self-doubt as aan admission, but there's very scant evidence about him actually making up stories. I'm not saying his method is our isn't flawed, it's just that the title belies the story. The struggle with his sexuality is the main subject and only small bits are about his uncertainty of his work. You're leaving out that he made up stories, and admitted it in private. Also that the article looked at primary sources, and saw that things that he said were not true. You're just making it look like the article is picking on a troubled, vulnerable person for being troubled and vulnerable, and ignoring the elements of the article inconvenient to that, such as the mild-mannered, introverted patient made disruptively ultra-sexual by L-dopa who had actually been an enthusiastic rapist and who no one described as shy and introverted. Or the audio recordings of a woman being told how she felt by him (and denying it), and how she was described that way in the books. Or how he put quotes from his own interests into his patients mouths. > there's very scant evidence If you ignore it, there isn't any. Do you think there's some threshold of quotes you're allowed to make up, or abilities you're allowed to give to people that they don't have (like the prime number thing, that even involved a fictional book), or a particular number of lies you get to tell about someone's past before it becomes dishonest? I have no idea what motivates people to make excuses like this for professional dishonesty. Sometimes I just think it's celebrity worship, but other times I think it's because people are dishonest in their own professional lives, and want to be excused by proxy.
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