A Leg to Stand On

by Oliver Sacks, M. D.

  The apparent sound of this soft, insinuating, inner voice suddenly woke me, sobered me and filled me with alarm. It was not “a nice place” to rest and nap. The suggestion was lethal and filled me with horror, but I was lulled by its soft, seductive tones.

  “No,” I said fiercely to myself. “This is Death speaking—and in its sweetest, deadliest Siren-voice. Don’t listen to it now! Don’t listen to it ever! You’ve got to go on whether you like it or not. You can’t rest here—you can’t rest anywhere. You must find a pace you can keep up, and go on steadily.”

  This good voice, this “life” voice, braced and resolved me. My trembling stopped and my faltering too. I got going once more, and didn’t falter again.

  * * *

  —

  There came to my aid now melody, rhythm and music. Before crossing the stream, I had muscled myself along—moving by main force, with my very strong arms. Now, so to speak, I was musicked along. I did not contrive this. It happened to me. I fell into a rhythm, guided by a sort of marching or rowing song, sometimes the Volga Boatmen’s Song, sometimes a monotonous chant of my own, accompanied by these words “Ohne Haste, ohne Rast! Ohne Haste, ohne Rast!” (“Without haste, without rest”), with a strong heave on every Haste and Rast. Never had Goethe’s words been put to better use! Now, I no longer had to think about going too fast or too slow. I got into the music, got into the swing, and this ensured that my tempo was right. I found myself perfectly co-ordinated by the rhythm—or perhaps subordinated would be a better term: the musical beat was generated within me, and all my muscles responded obediently—all save those in my left leg which seemed silent—or mute? Does not Nietzsche say that when listening to music, we “listen with our muscles”? I was reminded of my rowing days in college, how the eight of us would respond as one man to the beat, a sort of muscle-orchestra conducted by the cox.

  Somehow, with this “music,” it felt much less like a grim anxious struggle. There was even a certain primitive exuberance, such as Pavlov called “muscular gladness.” And now, further, to gladden me more, the sun burst from behind the clouds, massaged me with warmth and soon dried me off. And with all this, and perhaps other things, I found my internal weather was most happily changed.

  It was only after chanting the song in a resonant and resounding bass for some time that I suddenly realized that I had forgotten the bull. Or, more accurately, I had forgotten my fear—partly seeing that it was no longer appropriate, partly that it had been absurd in the first place. I had no room now for this fear, or for any other fear, because I was filled to the brim with music. And even when it was not literally (audibly) music, there was the music of my muscle-orchestra playing—“the silent music of the body,” in William Harvey’s lovely phrase. With this playing, the musicality of my motion, I myself became the music—“You are the music, while the music lasts,” as T. S. Eliot wrote. A creature of muscle, motion and music, all inseparable and in unison with each other—except for that unstrung part of me, that poor broken instrument which could not join in and lay motionless and mute without tone or tune.

  As a child I had once had a violin which got brutally smashed in an accident. I felt for my leg, now, as I felt long ago for that poor broken fiddle. Admixed with my happiness and renewal of spirit, with the quickening music I felt in myself, was a new and sharper and most poignant sense of loss for that broken musical instrument which had once been my leg. When will it recover? I thought to myself. When will it sound its own tune again? When will it rejoin the joyous music of the body?

  * * *

  —

  By two o’clock the clouds had cleared sufficiently for me to get a magnificent view of the fjørd beneath me, and of the tiny village I had left nine hours before. I could see the old church, where I had heard Mozart’s great Mass in C Minor the previous evening. I could almost see—no, I could see—individual figures in the street. Was the air abnormally, uncannily, clear? Or was there some abnormal clarity in my perceptions? I thought of a dream related by Leibniz, in which he found himself at a great height overlooking the world—with provinces, towns, lakes, fields, villages, hamlets, all spread beneath him. If he wished to see a single person—a peasant tilling, an old woman washing clothes—he had only to direct and concentrate his gaze: “I needed no telescope except my attention.” And so it was with me: an anguish of yearning sharpened my eyes, a violent need to see my fellow men and, even more, to be seen by them. Never had they seemed dearer, or more remote. I felt so close, watching them as through a powerful telescope, and yet utterly removed, not part of their world. If only I had a flag, or a flare—a rifle, a carrier-pigeon, a radio-transmitter! If only I could give a truly Gargantuan yell—one which would be heard ten miles away! For how could they know that here was a fellow creature, a crippled human being, fighting for his life 5,000 feet above them? I was within sight of my rescuers, and yet I would probably die. There was something impersonal, or universal, in my feeling. I would not have cried “Save me, Oliver Sacks!” but “Save this hurt living creature! Save life!,” the mute plea I know so well from my patients—the plea of all life facing the abyss, if it be strongly, vividly, rightly alive.

  An hour passed, and another, and another, under a glorious cloudless sky, the sun blazing pale-golden with a pure Arctic light. It was an afternoon of peculiar splendor, earth and air conspiring in beauty, radiant, tranquil, suffused in serenity. As the blue and golden hours passed, I continued steadily on my downward trek, which had become so smooth, so void of difficulties, that my mind could move free of the ties of the present. My mood changed again, although I was to realize this only later. Long-forgotten memories, all happy, came unbidden to my mind: memories, first, of summer afternoons, tinged with a sunniness which was also happiness and blessedness—sun-warmed afternoons with my family and friends, summer afternoons going back into earliest childhood. Hundreds of memories would pass through my mind, in the space between one boulder and the next, and yet each was rich, simple, ample, complete, and conveyed no sense of being hurried through.

  Nor was it a flitting of faces and voices. Entire scenes were re-lived, entire conversations re-played, without the least abbreviation. The very earliest memories were all of our garden—our big old garden in London, as it used to be before the war. I cried with joy and tears as I saw it—our garden with its dear old iron railings intact, the lawn vast and smooth, just cut and rolled (the huge old roller there in a corner); the orange-striped hammock with cushions bigger than myself, in which I loved to roll and swing for hours; and the enormous sunflowers, whose vast inflorescences fascinated me endlessly and showed me at five the Pythagorean mystery of the world. (For it was then, in the summer of 1938, that I discovered that the whorled florets were multiples of prime numbers, and I had such a vision of the order and beauty of the world as was to be a prototype of every scientific wonder and joy I was later to experience.) All of these thoughts and images, involuntarily summoned and streaming through my mind, were essentially happy, and essentially grateful. And it was only later that I said to myself “What is this mood?” and realized that it was a preparation for death. “Let your last thinks all be thanks,” as Auden says.

  At about six, rather suddenly, I noticed that the shadows were longer, and that the sun was no longer high in the heavens. Some part of me, Joshua-like, had thought to hold the sun in mid-course, to prolong to eternity the gold and azure afternoon. Now, abruptly, I saw that it was evening, and that in an hour, more or less, the sun would set.

  It was not long after this that I came to a long transverse ridge commanding an unobstructed view of the village and fjørd. I had attained this ridge at about ten in the morning: it had been about half-way between the gate and the point where I fell. Thus what had taken me little more than an hour to climb, had taken me, crippled, nearly seven hours to descend. I saw how grossly, how optimistically, I had miscalculated everything—comparing my “rowing” to striding, when it
was, I could now see, six times as slow. How could I have imagined that one was half as fast as the other, and that the ascent from the relatively warm and populous low-lying farmland, which had taken four hours or so, could be retraced in just twice that time, bringing me within range of the highest farmhouse by dusk or nightfall. I had hugged to myself, like a warm comforter, in the long hours of my journey—interspersed with my exalted thoughts—a warm sweet vision of the waiting farmhouse, glowing softly like a Dutch interior, with a dumpy, motherly farmwife who would feed me and revive me with love and warm milk, while her husband, a dour giant, went to the village for help. I had been secretly sustained by this vision throughout the interminable hours of my descent, and now it vanished, suddenly, like a candle blown out, on the chill clarity of that high transverse ridge.

  I could see, now, what had been shrouded in mists on the way up in the morning, how far away, unattainably far, the village still was. And yet, though hope had just expired and died, I took comfort from seeing the village, and especially the church, gilded, or rather crimsoned now, in the long evening light. I could see straggling worshippers on their way to evening service and had the strangest persuasion that the service was for me. It came to me once more, and overwhelmingly, how I had sat in that church only the evening before, and heard the C minor mass, and so powerful was the memory that I could actually hear it in my ears—hear it with such vividness that I wondered, for a long second, whether it was again being sung below, and wafted up to me, miraculously, by some trick of the air. As I listened, profoundly moved, with tears on my face, I suddenly realized that it was not the mass that I was hearing—no, not the mass, but the Requiem instead. My mind, my unconscious, had switched one for the other. Or was it—again that uncanny acoustic illusion—was it that they were singing the Requiem, down there for me?

  Shortly after seven the sun disappeared, seeming to draw, as it did so, all color and warmth from the world. There were none of the lingering effulgences of a more temperate sunset—this was a simpler, sterner, more Arctic phenomenon. The air was suddenly grayer, and colder, and the grayness and coldness seemed to penetrate right to my marrow.

  The silence had become intense. I could no longer hear any sounds about me. I could no longer hear myself. Everything seemed embedded in silence. There were odd periods when I thought I was dead, when the immense calm became the calm of death. Things had ceased to happen. There was no happening any more. This must be the beginning of the end.

  * * *

  —

  Suddenly, incredibly, I heard a shout, a long yodelling call which seemed very close to me. I turned, and saw a man and a boy standing on a rock, a little above me, and not ten yards from the path, their figures silhouetted against the darkening dusk. I never even saw my rescuers before they saw me. I think, in those last dark minutes, that my eyes had been fixed on the dim path before me, or had perhaps been staring unseeing into space—they had ceased to be on the look-out, constantly roving and scanning, as they had been at all times in the course of the day. I think, indeed, that I had become almost totally unaware of the environment, having, at some level, given up all thoughts of rescue and life, so that rescue, when it came, came from nowhere, a miracle, a grace, at the very last moment. In another few minutes it would have been too dark to see. The man who yodelled was just lowering a gun, and the youth by his side was similarly armed. They ran down towards me. I needed no words to explain my condition. I hugged them both, I kissed them—these bearers of life. I stammered out, in broken Norwegian, what had happened on the heights, and what I could not put into words I drew in the dust.

  The two of them laughed at my picture of the bull. They were full of humor, these two, and as they laughed I laughed too—and suddenly, with the laughter, the tragic tension exploded, and I felt vividly and, so to speak, comically alive once again. I thought I had had every emotion on the heights, but—it now occurred to me—I hadn’t laughed once. Now I couldn’t stop laughing—the laughter of relief, and the laughter of love, that deep-down laughter which comes from the center of one’s being. The silence was exploded, that quite deathly silence which had seized me, as in a spell, those last minutes.

  The men were reindeer hunters, father and son, who had pitched camp nearby. Hearing a noise outside, a movement in the undergrowth, they had come out cautiously with their rifles at the ready, their minds on the game they might bag, and when they peered over the rock they saw that their game was me.

  The huntsman gave me some aquavit from a flask—the burning liquid was indeed the “water of life.” “Don’t worry,” he said, “I go down to the village. I will be back within two hours. My son will stay with you. You’re safe and sound—and the bull won’t come here!”

  From the moment of my rescue my memories become less vivid, less charged. I was in others’ hands now and had no more responsibility to act, or feel. I said very little to the boy, but though we hardly spoke I found great comfort in his presence. Occasionally he would light me a cigarette—or pass me the aquavit his father had left. I had the deepest sense of security and warmth. I fell asleep.

  It was less than two hours before a posse of stout villagers arrived carrying a litter—on to which they loaded me, with considerable difficulty. The flailing leg, which had lain silent and unnoticed for so long, objected loudly, but they carried me gently, rhythmically, down the steep mountain trail. At the gate—the gate, whose warning sign I had ignored!—I was transferred on to a sort of mountain tractor. As it jogged slowly downhill—first through the woods, and then through orchards and farms—the men sang softly among themselves, and passed the aquavit around. One of them gave me a pipe to smoke. I was back in the good world of men.

  CHAPTER TWO

  Becoming a Patient

  What’s become of man’s great extent and proportion, when himself shrinks himself and consumes himself to a handful of dust?…A sick bed is a grave….Here the head lies as low as the foot—miserable and (though common to all) inhuman posture!…I cannot rise out of my bed till the physician enable me, nay I cannot tell that I am able to rise till he tell me so. I do nothing, I know nothing, of myself.

  —JOHN DONNE, Devotions

  “And so I was saved—and that’s the end of the story.” I had been through what I thought would be my last day on earth, with all the passions and thoughts attendant on this, and now—to my incredulous surprise and joy I found myself very much back on earth, with a stupid broken leg into the bargain. From this point there ceased, in a sense, to be any “story,” or any particular “mood” to give tension and connection to the days that followed. And thus it is difficult to write about them—difficult even to remember them vividly. I had observed this on the mountain, as soon as I had the certainty, the comfort, the assurance, of being safe—a sudden relinquishment, and perhaps exhaustion, of feeling—for profound and passionate feelings were no longer needed, no longer suited to my changed and, so to speak, prosaic position—so different from the tragedy, comedy and poetry of the mountain. I had returned to the prose, the everydayness, and, yes, the pettiness of the world.

  And yet, there was to be another story or, perhaps, another act in the same strange complex drama, which I found utterly surprising and unexpected at the time and almost beyond my comprehension or belief. I thought of these, for a time, as two separate stories, and it was only gradually that I came to see that they were essentially connected. But in terms of feeling at the time the next four days were somewhat dull—even though they included a massive and essential operation, the operation which links the two—and I can recall only certain high points, and low points, which stood out from the overall flatness of that time.

  I was taken to the local doctor—himself a red-faced son of the soil, with a practice covering a hundred square miles of the rugged mountain and fjørd country around—who made a swift and decisive, yet unhurried, examination.

  “You’ve torn the quadricep
s off,” he said. “I don’t know what else. You will have to be taken to hospital.”

  He arranged an ambulance, and alerted the nearest hospital, about sixty miles away, at Odda.

  Shortly after I had been settled in the little ward at Odda—it was a cottage hospital, with only a dozen beds or so, and simple facilities to cover the common needs of the community—the nurse came in, a lovely creature, though indefinably rigid and graceless in her movements.

  I asked her name.

  “Nurse Solveig,” she replied, stiffly.

  “Solveig?” I exclaimed. “That makes me think of Peer Gynt!”

  “Nurse Solveig, please—my name doesn’t matter. And now, be so kind, please, and turn over. I have to insert the rectal thermometer.”

  “Nurse Solveig,” I replied, “can’t you take my temperature by mouth? I am in a good deal of pain, and my damn knee will go out on me if I try to turn over.”

  “I cannot help that,” she answered coldly. “I have my orders, and I have to follow them. It is a hospital rule—rectal temperature on admission.”

  I thought to argue, or plead, or protest, but the expression on her face showed that this would be useless. Abjectly, I turned on my face, and the leg, unsupported, fell and prolapsed excruciatingly at the knee.

  Nurse Solveig inserted the thermometer and disappeared—disappeared (I timed it) for more than twenty minutes. Nor did she answer my bell, or come back, until I set up a shindy.

  “You should be ashamed of yourself!” she said, as she returned, her face pink with rage.

  The patient next to me, a young man quite breathless from severe asbestosis, with a good colloquial knowledge of English, whispered, “She’s a horror, that one. But the others are nice.”