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sacksThe greatest mystery is the human brain, and  Oliver Sacks is the ultimate detective.

Oliver Sacks is a neurologist who writes with the imagination of a poet and with the sharp curiosity of the dedicated scientist. He delights in the variety of human experience and in the ways the human brain develops and copes with damage – whether genetic, psychological or through injury – and he passes on his delight and amazement to his readers.

The first book I read by Oliver Sacks was Seeing Voices, a discussion of the  cultural world of the deaf, and the history and development of Sign as a language in various places and at various times. My oldest daughter is deaf, so this resonated with me in a particular way.

Since then, I’ve read everything he’s written, including the bestselling The Man Who Mistook His Wife for a Hat and Awakenings, both later made into films. (Another of his books, An Anthropologist on Mars, was screened as the award-winning The Music Never Stopped.) In these books his case histories are shaped like the best fiction and his anonymous patients are fascinating protagonists in the grand narrative of human consciousness.

In Hallucinations, Sacks looks at the nature of non-existent phenomena, real as they are to those who experience them. Sensory hallucinations include smell, voices, apparitions, ‘hearing things’, and ‘altered states’ of being. They’re experienced by alcoholics, drug-users, epileptics and the delirious, among others, as well as the aged when they begin to lose their other senses. Schizophrenia, however, Sacks believes deserves a book of its own, and he only briefly refers to it here.

The first recorded use of the word ‘hallucination’ is in the 1830s; its literal meaning is ‘wandering around in the mind’. Sacks defines hallucination as perception in the absence of external reality – experiences of things that are not there or are not perceptible to others, that have no ‘consensual validation’; experiences that are not able to be conjured up – they simply happen.

He describes the ways that hallucinatory experiences have been important to art, culture, folklore and religion – and the way some societies have deliberately sought and used hallucinatory drugs for sacramental purposes.

In the Introduction, he says:

I think of this book … as a sort of natural history or anthology of hallucinations, describing the impact of hallucinations on those who have them, for the power of hallucination is only to be understood from first-person accounts.

Probably most of us have had some sort of hallucinatory experience. I vividly remember one of my own, when as a student I was put on some crude anti-psychotic drug by a psychiatrist who’d decided I was schizophrenic (when in fact I was depressed and not coping well with university life). It was my turn to go to the markets and shop for our shared household, and halfway through I realised that the vegetables had grown faces and were jeering and laughing at me. It was some time before my housemates came over to see where I was and found me cowering, terrified, under a trestle table. I didn’t take any more of the pills.

Hallucinations deals with medical and other conditions that induce hallucination and the way recent technology has made it possible to approximately map some areas of the brain that are affected in various cases, as when the deaf ‘hear’ music, the blind ‘see’ colours, people and objects and amputees ‘feel’ their missing limbs.

Sacks devotes some time to actual hallucinogenic substances and the deliberate inducing of hallucination, including his own experiences with amphetamines and LSD. He also interweaves his scientific and pharmacological explorations with a cultural and literary history ranging from De Quincey and Joan of Arc through Dostoevsky, Coleridge and Timothy Leary.

The first chapter discusses Charles Bonnet Syndrome, whose sufferers know their hallucinations are not ‘real’ and do not become persistently deluded. Sacks refers to a blind patient named ‘Rosalie’, whose first (visual) hallucinations are benign and interesting:

‘People in Eastern dress … In drapes, walking up and down stairs … a man who turns towards me and smiles but he has huge teeth on one side of his mouth. Animals, too. I see this scene … and it is snowing – a soft snow, it is swirling. I see this horse (not a pretty horse, a drudgery horse) with a harness … I see a lot of children… They wear bright colours – rose, blue – like Eastern dress.’

These hallucinations subside, but some time later they come back in a not so benign form when Rosalie has been under stress.

Hallucinations doesn’t dwell as long on individual patient-centred stories as in some of Sacks’s other works – although, as with Rosalie’s case, there are first-hand accounts sprinkled through the text – and so the book doesn’t offer that particular empathy of reading in depth about other people’s unusual experiences. But, if this a lack, it’s more than made up for by Sacks’s breadth of knowledge and understanding and his constant striving to explain the mystery at the heart of human existence, or, more correctly, the brain, while acknowledging that there are still mysteries and that science may never be able to explain them all – mysteries whose answers lie not with religion, mysticism, the paranormal or the occult, but physically within us. Again, with Hallucinations, Sacks inspires us to wonder at and celebrate the variety of human experience and versatility.

Oliver Sacks Hallucinations, Picador, 2012, PB, 256pp, $29.95

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