Q&A: An Interview with Oliver Sacks

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Do you think you were addicted?

Certainly, it became a habit and I had a ritual. It was my weekend treat for two or three years. And then, mercifully, that was it.

What changed?

An odd experience, which I’ve written about. In 1966, I started working with migraine patients. I didn’t enjoy neurological training that much but when I started working with real patients and I had responsibility — that, I loved. They would tell you all sorts of things, which were mysterious to me and not well described in the current literature. (More on Time.com: The Lab Rat: How to Improve Memory in 15 Minutes)

I went back and found an old book on migraines from the 1860s. I took it out on a Friday evening. [I took amphetamine.] With an almost catatonic concentration, almost without blinking or licking my lips, I read the entire book from first to last word without stopping. I thought it was a marvelous example of Victorian medicine.

Then, I thought, it’s the 1960s — we need such a book now. Who should [the author] be? Now a disingenuous clamor of names went through my mind, followed by a very loud internal voice that said, “You, you bugger. You’re the man.”

I would usually come down from these amphetamine highs with a sense of folly, exhausted and empty-handed. But this time, the sense of revelation and resolution persisted and I wrote my own book and I never took another amphetamine again.

From your experience, it sounds like you are lucky not to have gotten more attached to the drug.

Very. I had friends who O.D.’ed on that stuff, and I was lucky not to myself. I don’t know that I recommend any drugs, but I think amphetamines are particularly dangerous and seductive. Whether addictive is the right word I don’t know.

How would you define addiction?

I’ve never attempted to. I regret now that I used the word. I think one defining characteristic could be requiring a larger and larger dose to get the same effect, and having severe withdrawal effects if you don’t take it. I don’t actually think that either of those was the case with amphetamine.

The DSM now defines it as compulsive use despite negative consequences, essentially.

I very much like “compulsive use despite negative consequences”; it’s a very concise definition. It puts it well. (More on Time.com: The Authentic Self: How Do You Know If You’re ‘Really’ Racist or Sexist?)

When I had knee replacement and then, almost on top of it, back surgery, we were told there was a window of no more than eight weeks in which you have to move; [otherwise], you will not get any more range of flexion. However, they said, bending the leg and knee is going to be very painful. In fact, it will be 10 out of 10 [on a scale of pain]. But you must do it. We are happy to give you morphine.

Now, one wonders, “Will I become addicted to the stuff?” But my own experience, like many people’s, was that when there was less pain there was less interest [in taking the drug].

My behavior with opiates was nothing like my behavior with amphetamine. I now have a large bottle of 30 or 40 [opiate] tablets that I didn’t use and have no interest in using, whereas I wouldn’t dare have any amphetamine in the house, even though it has been more than 40 years. I wouldn’t want a taste of it — well, I would want! I suspect there are some long lasting brain changes.

But I think its very cruel and ignorant to deny pain medication to people, especially people with intractable or permanent pain. It’s monstrous.

You have a pretty long view of the field of neuroscience. What is the most important advance you’ve seen?

At a gross, technological level, I think imaging, especially functional imaging of the brain. Even 20 or 30 years ago, no one would have imagined that you could get detailed pictures of people’s brains when they are listening to music or composing music or making up their mind to do something, or hesitating or, I don’t know, in love or rage.

At a finer level maybe just [understanding] the sheer complexity of 100 billion neurons, each of them with 1,000 or 10,000 dendrites [connecting them to each other]. I think now we can begin to understand some of the powers and some of the potentials of the brain as never before. But I think we can only do it in a rudimentary sort of way.

More on Time.com:

What Goes on Inside the Brain of a Misbehaving Boy?

Amnesia and a Camera: Photos as Memories

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