
Oliver Sacks was once crowned “the poet laureate of medicine."
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Amy Padula
I recently sat down with one of my favorite writers.
Rachel Aviv
I'm Rachel Aviv and I'm a staff writer at the New Yorker.
Amy Padula
But I called her up to talk about a different writer.
Rachel Aviv
I think I remember the first story I pitched for the New Yorker. I like tried to make it clear, like, don't worry, I'm not trying to do an Oliver Sacks piece because I didn't want them to think that I was daring to compete. I really admired his ability to just like delve into deeply into the inner life of one person.
Amy Padula
The late neurologist and best selling author Oliver Sacks. He's been referred to as the Poet Laureate of Medicine.
Rachel Aviv
He was like sort of like almost a figurehead for medical humanities in a way. Like this idea that we have been focusing too much on symptoms and data and that there is a human life behind all of this information.
Amy Padula
Oliver Sacks did something kind of wild for his time. He was a medical doctor who wrote intricate stories about the inner lives of his own patients.
Rachel Aviv
I do remember being in my early 20s reading a piece he'd written about a man who was blind and was sort of grappling with the possibility of regaining his sight. I loved how he was focused on one person, sort of one person's journey. He was so focused on the inner life of this person and that it was so textured, kind of was like, how did he know those details? How did he know that that man
Amy Padula
was thinking that maybe the best example of one of these Stories is from the book Awakenings, which he published in the early 1970s. He writes about spending 15 hour days at a hospital with a group of patients suffering from a disease called encephalitis lethargica, a sickness that left them catatonic, basically asleep while awake.
Rachel Aviv
Patients that no other doctors were really paying attention to and kind of developing a like wordless rapport with people that were really easy to dismiss as sort of not fully cognizant. And he spent so much time with them that he was able to sort of detect that they were not like comatose in the way that other people thought they were.
Amy Padula
That book was adapted for the screen and became an Academy Award nominated film. It starred Robert De Niro as a patient named Leonard and Robin Williams, who played a fictional Oliver Sacks. Towards the end of the movie, he gives a speech about the awakening of the human spirit.
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Amy Padula
Basically, he meant human connection could somehow awaken the spirit beyond medical care alone. Late last year, Rachel wrote a huge magazine story about Oliver Sacks for the New Yorker.
Rachel Aviv
I became aware that Oliver Sacks had
Amy Padula
this enormous archive, an archive of diaries and letters that Sacks had kept over decades. He documented many, not just the lives of other patients, but his own experience as a patient in therapy. Rachel got in touch with his foundation and got permission to take a look.
Rachel Aviv
I was like, how is this possible that this amazing man was in therapy for 50 years? Like, what does a half century psychoanalytic process look like? I was just like, this man is so articulate about other people's psychic lives. What is happening in the therapeutic process and how, how much can someone change in 50 years of therapy? Like, how far does self knowledge go?
Amy Padula
Today we're gonna follow Rachel Aviv's journey through the life of one of the most famous science writers of our time. A profile of a man known for his truth telling in medicine, who Rachel
Rachel Aviv
discovered bent the truth in his journals. He would just sort of reflect on what he had done and try to make sense of it. And he would sort of think through like, art is the lie that tells the truth. Am I doing art or have I crossed a line?
Amy Padula
I'm Amy Padula. This is unexplainable. So for all of Oliver Sacks writing about the super intimate details about the lives of patients, he didn't share much about his own life with the public. For most of his career. In a 2002 interview, he said that his severe shyness, which he described as a disease, had been a lifelong impediment to his personal relationships. And for most of his life, he lived alone. What were some of the most surprising anecdotes or sort of things you learned about what was going on for him in his personal life?
Rachel Aviv
One of the most amazing sets of correspondence that I read was Sachs's letters to this man who lived in Berlin at the time. And they had met in Europe. They'd had this like whirlwind romance. And then Sachs moved to New York.
Amy Padula
After a couple weeks, Sachs went back home to New York City and the two start writing to each other.
Rachel Aviv
And then their entire sort of affair took place in these letters. And they were just like thrilling letters. Each one, it was like Sachs was trying to outdo himself, to find new expressions of, like, the intensity of his love and his sense that he was merging with this man and that for the first time in his life, he felt at peace with being a gay man. He was seeing the world through new eyes.
Amy Padula
Sachs wrote about these intense feelings. There's a line that describes his happiness. I wonder if you could recall it.
Rachel Aviv
My blood is like champagne. And then two weeks passed in which he didn't get a letter from this man. And suddenly, like, all of Sachs kind of euphoria turned in on him and he started to think like, I was delusional, like I was part of a two man delusion, like, this was never love. I'm always going to be alone and I always have.
Amy Padula
The man eventually wrote to apologize, but for Sachs, the damage was done.
Rachel Aviv
And he was like, yeah, this is the truth. I will be in a spiritual cell for my entire life. And he finally just completely cut off the relationship with this man and then began to feel suicidal, which led to him beginning therapy for the next 50 years.
Amy Padula
After that early relationship, Sachs suffered. He couldn't make friends, he couldn't connect with people. He became celibate and wrote obsessively.
Rachel Aviv
Some of his correspondence with other gay men in the 50s and 60s and 70s and even 80s, like the sort of anguished state of being a gay man at that time. I think it's easy to almost forget how excruciating it was then. And so many of the people he was corresponding with, they would be like testing the waters to see if they could reveal to the other one that they were gay. There was so much sort of self hate and sort of tortured conversation around it 30, 40 years ago felt really Alive in his letters as well as his journals. Just the sense of like self punishing, self hiding experiences. I could see how he was sort of expressing a feeling of stuckness in life.
Amy Padula
Was there a moment in the reporting where you started to realize that his personal life was seeping into the work?
Rachel Aviv
So I had read many of his letters. I went back and I did a lot of rereading because it was like the first time I read everything, I didn't know what I was looking for. And then there would be times like at one point I was rereading Awakenings and I remember reading one of the patients describing her blood as being like champagne, which was striking because I, you know, that's the phrase he'd used in his letters to this lover from Berlin. So there were just these kinds of. It was almost like rhymes between his own descriptions of himself and his descriptions of his patients.
Amy Padula
One of the most striking rhymes that she found had to do with a particular poem by Rilke. The poem is about a panther who feels trapped, caged. Where had you seen that poem before?
Rachel Aviv
It was in his letters to describe how he felt when he was trying to write his first book about migraines. And I just remembered that phrase. And then I searched through my notes and I saw another reference where he had also used that phrase in a letter to his therapist. So it was clearly an important poem for him in his own self conceptualization in these moments of crisis.
Amy Padula
The poem evoked something similar to the way Sacks was feeling in his journals about not being able to express his sexuality and his personal life, not being able to connect.
Rachel Aviv
And then I was reading Awakenings and I was reading the chapter about Leonard, who's sort of the star of the book.
Amy Padula
Leonard, played by Robert De Niro in the movie adaptation, suffers from a sleeping sickness. He lives in a sort of trance like state. Sachs gave patients like Leonard a drug called L dopa, which changes the brain's dopamine levels. In his book Awakenings, Sachs writes that Leonard would spell out answers to questions that Sachs asked him because he couldn't speak.
Rachel Aviv
I just noticed that he said that Leonard typed out on this like typing board that he felt like the panther and Rilkes poem.
Amy Padula
In the movie adaptation, Robin Williams, as Oliver Sacks reads that poem, his gaze
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from staring through the bars has grown so weary that it can take in nothing more. For him, it is as though there were a thousand bars and behind the thousand bars no world. As he paces in cramped circles over
Rachel Aviv
and over, I thought, like, that's a strange coincidence that his patient would happen to sort of cite this poem that had been so meaningful to Sachs. And then I became kind of more attentive to those moments.
Amy Padula
What was going through your mind as you saw these rhymes, as you put it, play out? Was there any betrayal you felt as a reader seeing this kind of, like, appear in the records?
Rachel Aviv
Yeah, I mean, I think that made me feel like, okay, well, I can't trust that any particular detail is true.
Amy Padula
Did Oliver Sacks know he was fabricating things?
Rachel Aviv
Yeah, it was really reading the journals after I had been reading them for a couple months when I just read a passage where he straight out says, you know, I feel like. So I can't remember the exact phrasing that he's feeling this sense of criminality and that he feels so guilty for making things up. I would say that a man who mistook his wife for a hat had a lot of fabrications in it. That book then made him extremely famous. And I think he felt a lot like much of the guilt that he expresses in his journals is about that particular book. But the strange thing is, when that book was about to be published, he wrote his brother and said, you might call these confabulations. They're sort of half story, half fable, half made up. He was pretty open about the status. So I don't know what happened in the publishing process. Somehow these were taken as, like, case studies that were supposed to be straight fact. And he seemed pretty clear early on that that's not what they were, at least to himself. But suddenly it became, like, wildly famous and he became this huge figure. Sachs himself says, like, this was my most flagrant fabrication. And it involved these two twins who had autism, who were institutionalized. And Sac said that they were, like, exchanging prime numbers up to, I think, 20 digits. And that finding got a lot of attention because, like, no one had known this to be a human capacity. And so psychologists and mathematicians had written about this with some really defending, like, the importance of this finding. And so that felt really like a space where a case study had actually had an impact on people's understanding of human capacities. So I think I tend to agree with Sachs that that was the most flagrant moment or transgression.
Amy Padula
Rachel's magazine story came out in December of last year, and it got people talking.
Rachel Aviv
I did see people on the Internet, like, putting on. Putting their own headlines on the piece and sort of making it all about. You know, he fabricated. That kind of felt sad to me because that didn't feel like if I wanted it to be more complicated, than just oh, let's dismiss Oliver Sacks. He was making stuff up.
Amy Padula
We'll be back after a short break.
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Is this Karen Ifill? Yes.
Rachel Aviv
My name is Harold Crick.
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I believe you're writing a story about me.
Amy Padula
You talked about how some of the comments that you saw in your piece, the sort of TLDR headline sax fabricated stuff, which is true, but you also said that was frustrating and I'm wondering
Rachel Aviv
why something interesting happened where I couldn't like tell you quite who or what, but it felt like there was a contingent of like anti science people on social media. It almost was like, oh look, this sort of liberal darling of science fabricated things like science is a sham. I guess I also just felt like the takeaway of my story, I did not want it to be just oh my God, let's throw Sachs out the window. He fabricated things. And so that seemed like there was some of that going on and I was sad about that. But it's within this much larger context of one man's sort of struggle during the time when he was fabricating a lot of other sort of literary stars were doing similar things. So it's also within a historical context. But yeah, I think there are moments in which to me it was almost the projection that was most striking, like taking phrases that he used to describe his own angst and sort of putting it onto his patients. I guess I wanted to think about how those fabrications or those sort of. Of exaggerations feel revealing of dynamics in the way we respond to this kind of writing and the way that other people respond to it and the kind of expectations we have for, like, what empathy as a writer looks like. I think it's more about this genre of writing that he inspired, this sort of telling tales about illness that are kind of supposed to inspire or show you, like, the secret gift of your illness. I think, like, if anything, I would want it to inspire, like, more kind of thinking about the relationship between, like, a writer and a subject, and particularly a sort of doctor and the patient subject, and how much. How much of ourselves we bring onto that encounter sometimes without realizing sometimes.
Amy Padula
Do you know how any of his patients felt about his rendering?
Rachel Aviv
Leonard's family loved him. They didn't necessarily think the book was all accurate, but they were just so grateful for the time and the care that he had put into that relationship. Like the families that Leonard and his mother just adored him, and the other patients I talked to as well really adored him. They didn't fundamentally care, you know, about how they were written about in this book. What they cared about was that there was this. Who was, like, sitting with them for hours trying to understand them and making them feel, you know, like. That they were someone who had a story to tell.
Amy Padula
A huge part of Sachs's life that Rachel's story eliminates was his ongoing struggle with his sexuality. After that early relationship in Berlin, he lived unhappily closeted and celibate for decades. You unpack some of his battles in therapy and how some of that was getting worked out in the writing. At one point in the piece, you suggest that Sack spent much of his life searching for love. He once wrote, we spend our lives searching for what we have lost, and one day, perhaps we will suddenly find it. I just wonder what you make of that as you were sort of seeing these patterns crop up in the work.
Rachel Aviv
I mean, that idea that in therapy you're, like, working through. I like that phrase, working through, because I think probably most writers choose subjects to some degree because they're working through ideas that are important or problematic to them, and then they sort of displace it onto these other subjects where they're working through. And it felt like he was, like, rehearsing this narrative, which was someone who is trapped in this cell, this sort of spiritual cell. This sense of being in a cage suddenly is kind of released and has this awakening. And many of his stories have that arc. And so then it was striking to see. I mean, it was almost like the longed for outcome that he keeps sort of playing out in his work.
Amy Padula
Do you think about what you do as a reporter any differently after learning about sort of how Sachs identified with his subjects? Do you think differently about what you do at all?
Rachel Aviv
I think it was like part of a. Like a longer conversation with myself. As I age as a writer, my curiosities change and my identifications change. And so therefore, like, when I'm writing a story about a family, for instance, like I'm going to. I might actually change the kinds of questions I'm looking at because of where I am in life, or I find that I'm often, like, writing about people with complicated relationships to work. And that's because there's a question I have about my own relationship to work or. So, yes, I think, like, writing is always a kind of working through. And in a way, I think that if it's not a working through, it's less rich. Like, if you're writing about something about which you have no sort of unsettled questions and curiosities, then the writing can be flatter for it. So I think you do want some of that kind of like, identification and projection energy, but it can be taken way too far and too far in unethical ways and in really problematic ways. So it feels like a subject that does have stakes in my life and in sort of any kind of writing.
Amy Padula
He was a physician treating them and a writer observing them. And I wonder if if anything came up for you in terms of, like, that split role.
Rachel Aviv
Yeah, I mean, I think there was some, like, problematic, like, RD Lang type stuff going on where, like, like, RD Lang is the psychiatrist who kind of wanted his patients with psychosis to, like. It was almost like he was bringing their psychosis to full fruition so that he could gain more insights about the nature of madness. And Sacks actually writes about that too, that kind of guilt that, like some of his patients with Tourette's syndrome, he would, like, want their tics to reach sort of tick as to become floridly symptomatic, essentially because he felt like in that process, he, as the writer and the researcher was sort of gaining more insight into the nature of the disease. And I think he, like, told himself that that could be good for the patient, while also sort of realizing it was fundamentally like, you know, helping his project.
Amy Padula
After he had become famous for books like Awakenings and the man who Mistook his wife for a hat. Sachs did this interview in 1989 with a reporter from PBS.
Rachel Aviv
100 years from now, how would you
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like to be remembered? I would like it to be thought that I had listened carefully to what patients and others had told me, that I'd try to imagine what it was like for them, and that I'd try to convey this and to use a biblical term, the feeling he bore witness.
Rachel Aviv
I think, like, bearing witness in medicine has come to mean, like, you are sort of present in someone's moment of suffering to allow them to feel that they are seen and they are heard and that they're not alone and that you're kind of, like, doing this thing where you're not turning away like other people. It's just too hard. This idea of bearing witness is very kind of central in medical humanities, but I don't know that you can bear witness and also, like, write a story about someone. Those are two very different acts. And I think Sachs was sort of merging them both and presenting a model of how both can be merged. And there's a lot of, like, self interest involved, or not self interest, but sort of you have, like, a. Your mind is doing. Calculating things when you're thinking about how someone becomes a story. And when you're bearing witness, I think you need to be blank in a way that you probably can't be, as sort of an authorial, like, imagination. Sachs said he wanted to be remembered as someone who bore witness, and I get that. But I also think that it is very hard to do that when you're, like, telling a sort of magical fable about someone's illness and sort of the gifts that it might have bestowed upon them.
Amy Padula
What I find so fascinating about this story is that there's Oliver Sacks the doctor and Oliver Sacks the writer, and Oliver Sacks the man. And what happens when all of those versions of Sachs collide into each other?
Rachel Aviv
I think anyone would kind of say that one of the genius things he did was to see all these patients who were in, like, comatose states and other doctors had dismissed them, and he saw something in them. Like, he felt a sense of identification because he also saw himself as, like, the living dead and someone who'd been buried alive. These were words that he used. I think he was capable of imagining that there was, like, a real person, there was, like, a real consciousness, a real lively intelligence, like, sucked away by this illness inside these people. And so he spent enough time with them to realize that that was true. So I think, like, part of that identification and Projection, like, allowed him to make the discoveries he made. And then the second half of that was that the projection and the identification sort of obscured the specificity and possibly, like, the suffering of what they were going through because he kind of made their lives beautiful. I'm curious, like, how we turn our own emptiness in our life into art and what the costs of that are, how we manage that through that process
Amy Padula
of bearing witness to other people. Sachs was also working through something in himself.
Rachel Aviv
I was also, like, moved by his honesty and the pain of kind of trying to figure that out himself. Everyone, like, hides things from themselves, but I felt like he really was trying to sort of figure out, like, both justify it and flagellate himself for it.
Amy Padula
By 2008, Oliver Sacks had met someone. Another writer. His name was Bill Hayes.
Rachel Aviv
He was a science writer. They had lunch one day, and it just sort of proceeded from there. At the end of his life, he falls in love. And I just loved that you could find love at age 76. He was so stuck for all of those years. He couldn't come out for all those years. He was doing his best to try. And it just. Yeah, that felt like sort of, I guess, tragic, but beautiful in a way. Like, just that. That sheer effort to sort of understand yourself even if you really can't.
Amy Padula
This episode was produced by me, Amy Padula. It was edited by Julia Longoria, with help from Joanna Solotarov, mixing and sound design from Christian Ayala, and music from Noam Hassenfeld. Melissa Hirsch checked the facts. Jorge just is our editorial director. Sally Helm and Meredith Hodnot are two of all the great poet laureates of Unexplainable and Bird. Pinkerton sat on the A train as it barreled towards Washington Heights. She figured someone might think she looked weird or something. She had a broken platypus guitar on her back, an octopus key around her neck, and a. A boomerang sticking out of her pocket. But, nope, just a normal day on the subway. As always, thank you to Brian Resnik for co creating the show with Noam and Bird. If you'd like to support this show and the journalism that VOX does, we would love it if you would become a member. It's really easy to do. Just go to Vox.com members. You'll get access to all of Vox's journalism. For those of you who have emailed us to let us know that you signed up because of Unexplainable, thank you. If you can't join our membership, though, that's okay. If you want to leave a nice review on your podcast platform. Five stars or a written review, we would really appreciate it a lot. Or if you want to tell someone in your life that they might want to listen to the show, those things make a real difference. Unexplainable is part of the Vox Media Podcast network. We'll be back soon with another episode about everything we don't yet know.
Rachel Aviv
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Date: March 23, 2026
This episode of Unexplainable delves into the complex life and legacy of Oliver Sacks, famed neurologist and celebrated writer often called the "Poet Laureate of Medicine." Host Amy Padula interviews Rachel Aviv, staff writer at The New Yorker, whose recent in-depth article examined Sacks’s private archives and explored both his literary approach and deeply personal struggles. Together, they unpack how Sacks’s own life—his sexuality, therapy, loneliness, and search for love—influenced, and at times blurred with, his portrayals of patients. The central focus: the boundary between truth and art in Sacks’s writing, and what it means for science, empathy, and the expectations we place on doctor-authors.
This episode skillfully peels back the layers behind Oliver Sacks’s famous case studies and literary persona, showing how his writings were shaped by private suffering, longing, and projection. From heartbreak and solitude to the guilty art of embellishment, Sacks’s life story asks deep questions about truth, empathy, and the costs and gifts of turning life into narrative. For anyone interested in science, biography, or the fuzzy border between fact and fiction, this is a powerful listen.