The Catastrophe

April 20, 2015 12:29 PM

He had always wanted his suicide to be high drama , but in the end he said nothing to anyone; he simply disappeared from sight and silently returned to the sea. Oliver Sacks looks at the last years of monologuist Spalding Gray's life, and the accident that precipitated a decline before his death. (Previously.)
posted by maxsparber (36 comments total)

I'm not sure if there's anything that fills me with more shaking-fists-at-the-heavens impotent existential rage than the loss of Spalding Gray and the imminent loss of Oliver Sacks.

I don't know that there's ever been any evidence that Gray's brain damage could have been better mitigated (at the time it happened with the technology available), but I am beyond ready for us to reach a stage in medicine where any suspected head injury is considered an emergent situation until proven otherwise. A broken hip is serious, a broken brain is worse.

*fist-shaking resumes*
posted by Lyn Never at 12:49 PM on April 20, 2015 [24 favorites]

The old sadness of Gray and the impending sadness of Sacks gives this story a real pointed sting for me. I had not realized before reading it that Gray had been injured and was so affected by it. I cannot imagine the horror of realizing that a knock to the head has robbed you of the thing that most defined you, and set you on the same path that killed your mothers years earlier.

It is vintage Sacks. Filled with medical details, but so human and so sad, and the last two were also true of Gray's work. The world is smaller without Gray, and will be smaller still without Sacks.
posted by maxsparber at 12:52 PM on April 20, 2015 [13 favorites]

It was surprising how thematically similar this felt to the movie Birdman (e.g., mental illness, an actor/artist scared at losing his creative powers, suicide as "performance").
posted by jonp72 at 1:03 PM on April 20, 2015 [1 favorite]

I was struck by Gray's suicide at the time, though I don't know if I would have been less surprised had I known this about him. I really wish we could have heard what he would've said about the last few years.
posted by wenestvedt at 1:14 PM on April 20, 2015

A sad and terrifying account, written (as always) superbly by Sacks. It's amazing how fragile we all are.
posted by xingcat at 1:21 PM on April 20, 2015 [2 favorites]

I enjoyed this thoughtful piece, but I did miss any note of "I have permission to write about the intimate details of my patient's and his family's lives" that I looked for.
posted by Dashy at 1:45 PM on April 20, 2015

I have no use for Sacks, who has always treated his patients like a freak show. But the loss of Spalding Grey still hurts.
posted by SPrintF at 2:09 PM on April 20, 2015 [3 favorites]

Dashy, I think this is actually an excerpt from Sacks' upcoming memoirs, as he retired from public life and work in February, and I'm sure his publisher, as well as the New Yorker, would not have published it without permission.

Kathie Russo has been very forthcoming about the mental/emotional/neurological difficulties Gray suffered in the years after the accident, there's not much in the way of groundbreaking information here.
posted by Lyn Never at 2:10 PM on April 20, 2015 [4 favorites]

SPrintF, that's an unusual reading of Sack's work. And from what I've read and heard, his patients would disagree with you.
posted by Frayed Knot at 2:13 PM on April 20, 2015 [12 favorites]

The NYer's fact checkers are second to none, so I expected that everything was kosher, but it still felt lurid to me. Just my opinion, of course.
posted by Dashy at 2:24 PM on April 20, 2015

I don't think I can handle reading what I'm sure is a lovely piece of writing, so I'll just leave this here.

.
posted by PMdixon at 2:32 PM on April 20, 2015 [1 favorite]

I'm afraid that I never really appreciated Spalding Gray when he was at his peak, and had little knowledge of the circumstances of his decline, but this is a very touching article, and pretty hard to read.
posted by metagnathous at 3:05 PM on April 20, 2015 [2 favorites]

SPrintF, could not disagree more about Sacks. His writing has always struck me as profoundly and unfailingly empathetic.

I feel so lucky to have seen Gray perform live in the early 90s.
posted by MACTdaddy at 3:53 PM on April 20, 2015 [6 favorites]

I wonder what they used for general anaesthetic? Seems like if I were in his shoes I'd be trying to get a steady supply of that, long-term effects be damned.
posted by Matt Oneiros at 3:57 PM on April 20, 2015 [6 favorites]

"Swimming to Cambodia" is a favorite. I loved Spalding. Thanks for posting this.
posted by clavdivs at 4:55 PM on April 20, 2015 [2 favorites]

I once heard Sacks introduce a documentary showing the patients he wrote about in "Awakenings", He then answered questions afterwards. I was struck by how fond he seemed of these former patients and came out thinking he was a very empathetic and kind man.
posted by acrasis at 5:00 PM on April 20, 2015

Sprintf, it seems clear to me reading this that Sacks truly cared about Gray. Also, everything I know about Gray suggests he would have wanted this story told. There's zero exploitation here.
posted by Ursula Hitler at 6:37 PM on April 20, 2015 [1 favorite]

Spalding Gray's death is all the more tragic because he likely would not have had such a severe brain injury had he been wearing a seatbelt. He might still be with us.

Losing Sacks will be a great loss to writing and to medicine.
posted by haiku warrior at 7:04 PM on April 20, 2015 [3 favorites]

All I know about Oliver Sacks is "The Man Who Mistook His Wife For A Hat." In every chapter, Sacks has an opportunity for a teaching moment, about the brain, about neurology. Instead, he offers up this syrupy drivel. I find him very condescending and dismissive of the patients charged to his care. He offers them up as exhibits in a carnival sideshow. I doubt that any of them wanted to help him push more books.
posted by SPrintF at 8:06 PM on April 20, 2015

SPrintF, well, I disagree. My dad had a big stroke in 2004 that left him with frontal-temporal damage. The impulsivity, self-absorption, and general weirdness was pretty rough on his friends and family. I haven't had a lot of experience with other people with frontal lobe damage, so I found this helpful - I felt like I was somewhat acquainted with Spalding Gray from his monologues, and this sensitive account illustrated that the personality changes that my dad underwent were rather reassuringly common. It doesn't change anything now - my dad died in 2007 of an unrelated cancer - but I can imagine that this might be helpful to other families dealing with survivors of major frontal lobe damage. (My dad's case had the added dimension of temporal lobe problems, which meant that he tended to confabulate, because he had big memory problems. With the ageing population, though, major memory problems are so unfortunately common that it's not as isolating.)
posted by gingerest at 8:30 PM on April 20, 2015 [5 favorites]

please dear god save me from head injuries

.
posted by jenfullmoon at 9:02 PM on April 20, 2015 [5 favorites]

While I disagree with you, SPrintF, I will say that your reaction is not outside of the expected range. This is a difficult topic and it can seem invasive to discuss the details of a personality change, precisely because we so closely identify the personality with the self. In many ways we still believe that one's behaviors make up the real person, and exposing oddities as does Sacks feels like disclosing the intimacies of the therapeutic couch.

But in my experience all of the cases he writes of are ultimately something that changes in the brain, or develops, or afflicts it, due to a physical, and in a sense unimpeachable, reason. The person is a victim. And to the extent that brain injuries and diseases are so common, explaining them is very helpful to those trying to figure out what is happening to their spouse, relative, or even themselves. I know we went through hell when my dad developed frontotemporal dementia, and began behaving in unrecognizable ways -- yet still retained enough of his own sense of self that he interpreted our actions in -- characteristically for the disease -- unempathetic ways. He was incapable of understanding his own illness, and that made it that much harder for us. I know that I looked into Alzheimer's and dementia symptom lists for a long time before FTD (or FTLD or Pick's) leaped out at us, months before we were able to obtain a confirming diagnosis. Had we had a clearer example in the media, in the way that Alzheimer's characteristics are now commonly understood, we might have eased that time of conflict somewhat, which is why I think that Sacks's work is important.

I also know that our own perspective is now that if anything we disclose can help another family get through the same circumstances with a little less pain, it's worth it.
posted by dhartung at 10:03 PM on April 20, 2015 [2 favorites]

I wonder what they used for general anaesthetic? Seems like if I were in his shoes I'd be trying to get a steady supply of that, long-term effects be damned.

Would be neat to know. Ketamine, isoflurane, and nitrous oxide have all been associated with short-term relief from depression in studies (and I guess anecdotally by a few :/ ).
posted by cotton dress sock at 10:32 PM on April 20, 2015 [3 favorites]

He offers them up as exhibits in a carnival sideshow.

I don't know how you came up with that. Sacks illustrates functional disturbances and talks about the underlying neurology, because that's his genre, the case study. I've never seen him not also describe the people he talks about in terms of their joys, strengths, relationships, or values, when he's had the opportunity to know them.
posted by cotton dress sock at 10:42 PM on April 20, 2015 [1 favorite]

Moreover, one of the people in "Hat" was himself; he didn't mention it at the time, but finally confessed to it. But not for the reasons you're thinking; he was the med student who'd suddenly developed a super enhanced sense of smell after having had a wild night of drugs.
posted by EmpressCallipygos at 12:52 AM on April 21, 2015

All I know about Oliver Sacks is "The Man Who Mistook His Wife For A Hat."

Then I think you're giving him pretty short shrift. There's a lot more to Sacks - a man with 60-odd years of career and many many books than this.

Also, have you seen any evidence of this kind of pushback from his patients? His work has included dozens by now, and I'm yet to see anything like that?
posted by smoke at 1:31 AM on April 21, 2015 [1 favorite]

Makes me recall this old story about being the guy who found his body.
posted by Peregrine Pickle at 3:05 AM on April 21, 2015 [1 favorite]

He was scheduled to perform in Tallahassee just before he went missing, and I'd been really looking forward to going with my wife to see the show. What a shame his loss was. He had such a unique gift for storytelling. I just can't see suicide as the powerful act of artistic authenticity some others do. It seems to me like a kind of unhealthy attachment to the idea of death as final and purifying, a kind of modernist puritanism. But Gray has my respect all the same.
posted by saulgoodman at 4:33 AM on April 21, 2015

I was fortunate enough to see Gray on one of his last tours, after his accident. In pinning down that date -- January of 2002 -- I'm struck by how rapid his decline was.

In June 2001, he has his car accident. Early the next year he is touring with an anniversary performance of "Swimming to Cambodia" and he also already reading from the work-in-progress "Life Interrupted." According to Sacks's account, Gray was already in a deep depression at this point. In retrospect, perhaps there was a certain level of bitterness in the performance and newer work, that I simply chalked up to that being common in an aging, idiosyncratic author. It was still a compelling performance, perhaps all the more so for the newer piece being so raw and close to the surface. And, of course, I was excited to see someone as special as Gray perform at all.

Eight months later, at the latest, he would begin the campaign of suicide attempts that would end with his death, two and a half years after his accident.
posted by He Is Only The Imposter at 5:30 AM on April 21, 2015 [1 favorite]

It's too enormously sad. I couldn't finish it.
I loved Spalding Grey, and his death was a hard pill to swallow. A great writer and performer.

.
posted by From Bklyn at 8:48 AM on April 21, 2015 [1 favorite]

Also, have you seen any evidence of this kind of pushback from his patients?

Even if there were none from this patient, Sacks should still include a disclaimer in his work. There's a power differential between all patients and doctors; and there's a law around patient privacy for good reason. Beyond that, it's the well-loved Oliver Sacks writing. I think we'd be highly unlikely to know about it if a patient objected to their story being made public.

He should include a disclaimer as an example for everyone doing medical writing: look, even I, the great Oliver Sacks, regard patient privacy and consent as something we must respect and uphold, every time.

It was that nod that I missed.
posted by Dashy at 8:58 AM on April 21, 2015

I disagree. The currently in-vogue idea that every writer should be forced to preface every piece of potentially offensive or even non-offensive writing with some sort of disclaimer is absurd. It irritates me when I come across writing that does carry a disclaimer, as if to pre-shield me from its contents.

I also disagree that Oliver Sacks is exploitive, any more than any other writer who doesn't write about himself or herself is exploitive. I find Sacks' writing wonderful to read and absorb, I learn something new every time I read it, and his imminent loss is depressing as hell.
posted by blucevalo at 9:15 AM on April 21, 2015 [1 favorite]

I think we'd be highly unlikely to know about it if a patient objected to their story being made public.

Considering that there are HIPAA laws in place specifically to prevent that, I think you're wrong, and also think the accusation that Sacks is telling his patients' stories without appropriate permissions is a derail without evidence that he is doing so.
posted by maxsparber at 9:16 AM on April 21, 2015 [1 favorite]

To be super clear, I do not mean a "trigger warning" or an "offensiveness disclaimer" but a statement like "I have this patient's (and his family's) permission to tell this story". There's a world of difference between those.
posted by Dashy at 9:19 AM on April 21, 2015

A paper [pdf] on the very question whether Sacks "has always treated his patients like a freak show".

TL;DR: it's complicated, as per usual.
posted by Pyrogenesis at 10:37 AM on April 21, 2015 [8 favorites]

Great piece, Pyrogenesis.
posted by smoke at 3:22 PM on April 21, 2015 [1 favorite]