Oliver Sacks and Melanoma of the Eye

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Oliver Sacks died this week at age 82 of a melanoma in his eye that was diagnosed 11 years ago and recently had spread to his liver. He was a neurologist who wrote more than a dozen popular books that sold millions of copies, making him probably the most-read physician-author in the world. His ideas were so unconventional that when he first presented them, doctors treated him as if he was a nut. Today most members of the medical profession accept at least some of his outlandish theories. He was a professor at the New York University School of Medicine, had been professor of neurology and psychiatry at Columbia University Medical Center and Albert Einstein College of Medicine, and received honorary doctorates from ten universities and medical schools. He was portrayed by Robin Williams in the Oscar-nominated movie Awakenings, based on one of his books.

Family and Early Years
Sacks was born in London in 1933 to Orthodox Jewish parents. His father was a physician who practiced into his 90’s, and his mother was one of the first female surgeons in England. His father once held his age-group record for swimming the 15 miles off the Isle of Wright in England, and his mother was a very good standing long jumper. Oliver was not the only notable member of his family; his first cousins included Israeli politician and author Abba Eban, writer and director Jonathan Lynn, Nobel Laureate Robert Aumann, and Al Capp, who wrote Li’l Abner, the most popular daily cartoon in America in the 1940s and 50s. (Al Capp bought sodas from me regularly when I worked as a soda jerk at a downtown Boston drugstore in the 1940’s.)

In 1939, to avoid the Nazi Blitz in London, six-year-old Oliver and his older brother were sent to the country to a horrible boarding school where they were starved, beaten and isolated. His brother returned as a schizophrenic who was never able to function in society and lived most of his life in his parents’ home. At age 18, Oliver entered Oxford University and received his degree in 1954. He was certified as a medical doctor in 1960, left England and received his training in neurology at UCLA.

Personal Life and Medical Career
He was short and very muscular with very large bones and weighed 190 pounds in his athletic prime, although in later years he ballooned up as high as 300 pounds. It was not until 2015, the year that he died, that he was able to write about his homosexuality in his autobiography On the Move. As a teenager, he first realized that he was homosexual, but kept it a dark secret. When he was 21, he went with his father to see his father’s hospitalized patients. His father asked him directly if he had a girlfriend. He said that he didn’t and his father asked why. He replied, “I guess that I do not like girls.” The next morning, his mother started to scream at him all kinds of biblical condemnations of homosexuality and then wouldn’t talk to him for several days. After that, neither parent ever mentioned the subject to him again.

oliver sacks He left England to get away from the prejudice against homosexuality and came to Canada and eventually to California where he had several liaisons. He started taking recreational drugs and drugs to enlarge his muscles. He spent much of his time in gyms lifting prodigious amounts of heavy weights. He got so strong that he once held the California record for a 600-pound full squat. He rode more than 100,000 miles on his motorcycle, rode with the notorious Hell’s Angels, and participated in reckless motorcycle races. He took some of his patients with multiple sclerosis or paraplegia who hadn’t moved in years, strapped them behind him and took them motorcycle riding in the mountains.

He got tired of his hell-bent lifestyle and in 1965, at age 33, he suddenly gave up drugs, motorcycles and bodybuilding and moved to New York. He said that he remained celibate for the next 35 years. He never married, and lived alone for most of his life in a small house in the Bronx, and maintained his neurology practice. In 2008, at age 75, he fell in love with the writer Billy Hayes, the author of The Anatomist (a story of Henry Gray, the author of Gray’s Anatomy). He swam most days and was able to swim continuously for hours. He was also an accomplished oarsman .

His Writings
In 1970, Sacks began to compile case histories of his unusual patients into books and magazine articles. He was a frequent contributor to The New Yorker and New York Review of Books. Perhaps the most beloved of his twelve books is The Man Who Mistook His Wife for a Hat, which includes the story of a patient who had lost the ability to recognize faces (prosopagnosia). Dr. Sacks suffered from this condition himself. He wrote case histories showing that the deaf could hear, the blind could see, people emotionally paralyzed by catatonia could dance, the mute could sing, those with autism could communicate and those with amnesia could remember. He had taught people who were color blind to taste colors, who were deaf to think that they heard music, and who were blind to visualize words. Awakenings, about his patients with encephalitis who had slept for decades and woke up when they were given a new drug called levadopa (L-dopa), was made into an Academy Award-nominated film, with Robin Williams in the role of Dr. Sacks and Robert deNiro as one of his patients.

Illness and Death
In 2006, he was diagnosed with a melanoma cancer in his right eye and was treated with radiation and laser therapy which left him blind in that eye, but gave him 11 more productive years. In 2015, the melanoma spread to his liver and killed him.

Malignant melanoma is a cancer that starts in the cells that produce pigment most commonly in the skin and less commonly in the eye. It is a frightening cancer because in some people it can spread rapidly throughout the body and kill them. A single sunburn can cause a melanoma as can any form of radiation, usually from sunlight. Symptoms of melanoma in the eye can include:
• bulging eyes
• changes in the color of the iris (the colored area around the dark pupil in the center of the eye)
• vision changes
• red, swollen or painful eyes
• small color defects in the eye
Check with an eye doctor if you notice any of these symptoms or other changes in your eyes.

Important Messages from Dr. Sacks’ Story
• Never criticize or ostracize a person just because he is different from you.
• Traumatic events in childhood can cause psychological damage that lasts for a lifetime.
• People with disabilities should be treated with respect and caring. Abnormalities in the brain are often the cause of many and different disabilities.
• Innovators and discoverers are often treated as quacks before their new ideas are finally accepted and honored.

Oliver Sacks
July 9, 1933 – August 30, 2015