I recently listened to a podcast about Oliver Sacks. It was an interview with Lawrence Weschler, who is promoting his book And How Are You, Dr. Sacks?: A Biographical Memoir of Oliver Sacks. Like everybody else, I knew of Oliver Sacks and his famous books, but I have not read those books and did not know much about the man himself.

Notably, I did not know that Oliver Sacks was gay. In our enlightened post-gay world, that would ordinarily be irrelevant to anything (“What does it matter that he was gay? He’s just a human. Why do you people obsess over sexual identity so much??”) but in Oliver Sacks’s case it seems to have been relevant. The story from the podcast went something like this:

  • Sacks had been a doctor, and had known he was gay. Other than a brief period in California, he had suppressed this, and was celibate for decades.
  • Sacks had his clinical practice, and had written Awakenings, but at the time the book was a flop. He was not taken seriously by his fellow doctors, partially because his research was qualitative, not quantitative.
  • He fell into a writer’s block characterized by logorrhea. He would write and write and write and be unhappy with all of it.
  • Weschler was a writer for The New Yorker and wanted to profile Sacks in the early 1980s — after Awakenings had been published, but before it became a bestseller. Over the course of four years, Weschler interviewed the man and spent time as he did his rounds. When Weschler was ready to write the profile, Sacks asked him not to do so if there was no way to conceal his homosexuality. Weschler thought that Sacks’s homosexuality was a part of the story, and so the profile got shelved.
  • Much later in life, Sacks accepted his sexuality enough to come out in his autobiography (published in 2015). Seven years before his death from cancer, he fell in love with a man and had a relationship.
  • As Sacks was dying of cancer, he finally gave Weschler permission to write the profile.

Why did Weschler feel that Sacks’s sexuality was relevant to his profile? He offered a couple of reasons. First: Sacks was tormented by his homosexual feelings. (He probably would have benefited from, but that has not yet been created.) He felt that he was an outcast. This gave him a lot of sympathy for his clinical subjects, who were people suffering from conditions too mysterious and too resistant to treatment for other doctors to care about. Weschler used the phrase “community of the refused.” Sacks felt that he himself was refused, and he tended to the medical needs of others who were refused, and identified with them when other well-adjusted doctors would not have bothered.

Secondly, Sacks knew drugs. Again according to Weschler, Sacks was sufficiently tormented (and insufficiently devoted to the blood of Jesus Christ) that for a few years he turned to drugs and became a speed freak. This helped him identify cases where drugs might have been helpful.

To these reasons I would add a third. You all came out early enough in life that I do not expect you to relate to this, but a common coping strategy for self-loathing, closeted, genetic dead-ends is throw ourselves into their careers. They hope that working hard enough and building up career accomplishments serves both as an excuse for not going on dates (“work is sooooo busy”) and as a justification for their existences. You don’t have to take my word for this; I plagiarized this concept from The Velvet Rage, a book by Alan Downs, a book well worth reading if you woke youngsters have trouble understanding how your gay elders got so messed up.

Let’s take Weschler at his word, and accept that there was some relationship between Sacks’s own despair surrounding his sexuality and his ability to relate to others. This raises some interesting hypotheticals relating to the justification of one’s existence. This is debatable (and if any of you read this far I am sure you will debate it), but for the sake of these hypotheticals let’s say that if Sacks had been able to direct more of his energy into sex and interpersonal relationships, he would have been less driven to administer to the “community of the refused”, and would not have accomplished as much in his career. What was Sacks’s personal torment worth?

Say that Sacks’s personal torment led to him being an innovative, influential doctor who then enlightened thousands of readers by writing bestselling books. Would that have been worth the torment?

Put aside the bestselling author bit. Say that Sacks’s torment had led to him being an innovative, influential doctor who helped humanize patients via “narrative therapy”. Would that have been worth the torment?

Put aside the innovative, influential doctor bit. Say that Sacks’s torment had pushed him to sympathizing with his patients and humanizing them on a personal level, helping to heal some people who were otherwise thought to be incurable? Would that have been worth the torment?

Put aside the curing bit. Say that Sacks’s torment had led him to be a more caring doctor who had real empathy for outcasts because he felt like an outcast himself, even if he was not able to cure significantly more people than indifferent doctors. Would that have been worth the torment?

Before you offer kneejerk reactions, consider the cost of self-acceptance. Even at the most modest level, patients who would have otherwise been ignored and treated like pieces of meat felt as if they were treated like human beings. Has a doctor’s demeanor ever had an effect on you? How much torment is a more sympathetic doctor worth to you or the ones you love?

You can argue that this is a false dichotomy all you like. I am sure you are completely correct, and that this idea that closeted self-loathing people overcompensate in their careers is just another delusion from my diseased little brain. There are no tradeoffs in this world. We can all have our cakes and eat them too.