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Oliver Sacks

What Oliver Sacks Ponders on the Final Straight of Life


A sky sprinkled with stars, lemurs that climb trees and elements of the periodic table that surround him as friends: this is what Sacks ponders in his last months of life.

Those of us who have encountered Oliver Sacks, via his books, videos or articles, consider him a loved one. On one layer he is the “poet laureate of medicine,” who brought music and art to marginalized patients, and underneath that, in the underlying layers that he has shown us, he is the most passionate of detectives of the small rarities and beauties of the world, among them ferns and minerals. Sacks, as we also know, is on the verge of death.

On July 24, 2015 he published a beautiful article in The New York Times announcing the terminal state of his metastases liver cancer. It is still not known how long he has to live, but his capacity for awe and his generosity, to the final moment of his life, do not cease to bear fruit. Sacks shares with us some impressions of the world seen in contrast to the unavoidable presence of death.

A few weeks ago, in the country, far from the lights of the city, I saw the entire sky “powdered with stars” (in Milton’s words). […] It was this celestial splendor that suddenly made me realize how little time, how little life, I had left. My sense of the heavens’ beauty, of eternity, was inseparably mixed for me with a sense of transience — and death.

I told my friends Kate and Allen, “I’d like to see a sky like that when I’m dying.”

“We’ll take you outside,” they said.

It is no surprise that, when he was a boy, Oliver Sacks made friends with and became a classmate of the numbers of the periodic table, that abstract and concise place bereft of life, but which is also bereft of death. There he found solace and fascination for the planet and its metals and minerals, and he forged a personal link with each one of them. More specifically, he celebrated his birthdays next to the element corresponding in number, and continues to do so irrespective of how weak he may feel on that day. “Auden used to say that one should always celebrate one’s birthday, no matter how one felt,” he points out.

And now, at this juncture, when death is no longer an abstract concept, but a presence — an all-too-close, not-to-be-denied presence — I am again surrounding myself, as I did when I was a boy, with metals and minerals, little emblems of eternity. At one end of my writing table, I have element 81 in a charming box, sent to me by element-friends in England: It says, “Happy Thallium Birthday, ”a souvenir of my 81st birthday last July; then, a realm devoted to lead, element 82, for my just celebrated 82nd birthday earlier this month. Here, too, is a little lead casket, containing element 90, thorium, crystalline thorium, as beautiful as diamonds, and, of course, radioactive — hence the lead casket.

The scientist recently began immunology therapy, in the hope that it will give him a few more good months. But before starting it he decided, and not without his characteristic and contagious inquisitive nature, to take a trip to North Carolina to see the wonderful lemur research center at Duke University.

Lemurs are close to the ancestral stock from which all primates arose, and I am happy to think that one of my own ancestors, 50 million years ago, was a little tree-dwelling creature not so dissimilar to the lemurs of today. I love their leaping vitality, their inquisitive nature.

He has thus dedicated the last few months to observing the “sky powdered with stars,” fascinated by the lemurs that connect us almost directly to the beginning of what we became (and that have so many characteristics similar to our own), and accompanying the elements of the periodic table, and above all by bismuth: that modest and ignored element of the periodic table that is number 83; a year he will perhaps not live to see (he is currently 82), and for which he has begun to feel a special affinity.

Next to the circle of lead on my table is the land of bismuth: naturally occurring bismuth from Australia; little limousine-shaped ingots of bismuth from a mine in Bolivia; bismuth slowly cooled from a melt to form beautiful iridescent crystals terraced like a Hopi village; and, in a nod to Euclid and the beauty of geometry, a cylinder and a sphere made of bismuth.

I feel there is something hopeful, something encouraging, about having “83” around. Moreover, I have a soft spot for bismuth, a modest gray metal, often unregarded, ignored, even by metal lovers. My feeling as a doctor for the mistreated or marginalized extends into the inorganic world and finds a parallel in my feeling for bismuth.

Sadly, Sacks may not live to reach the number of the bismuth, but it is there, by his side, to remind him of the idea of simple beauty and finiteness. On the other side of his desk (and also on the periodic table) is element 4, but that is rather there to remind him of his childhood and how much time has passed, how many metals and minerals, since he embarked on his very private and fruitful life that is now drawing to a close.

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