A Leg to Stand On

by Oliver Sacks, M. D.

  In order to judge what was a “reasonable distance,” in a “reasonable direction,” I found myself entirely dependent on external, or visual, landmarks—marks on the floor, or marks triangulated with reference to the furniture and walls. I had to work out each step fully, and in advance, and then advance the leg, cautiously, empirically, until it had reached the point I had calculated and designated as secure.

  Why did I “walk” in this ludicrous fashion? Because, I found, I had no choice. For if I didn’t look down, and let the leg move by itself, it was liable to move four inches or four feet, and also to move in the wrong direction—for example, sideways, or, most commonly, at randomly slanting angles. On several occasions, indeed, before I realized I would have to program its movements in advance and monitor them constantly, it “got lost,” and almost tripped me up, by somehow getting stuck behind, or otherwise entangled with, my normal right leg.

  The unreality was still extreme. It wasn’t “my” leg I was walking with, but a huge, clumsy prosthesis, a bizarre appendage, a leg-shaped cylinder of chalk—a cylinder, moreover, which was still constantly altering, fluttering, in shape and size, as if I was operating a peculiarly clumsy, and unstable, robotic contraption, an absolutely ludicrous artificial leg. I cannot convey, except in this way, how strange this pseudo-walking was—how entirely lacking in any sense, and, conversely, how overloaded with a painstaking mechanical exactitude and caution. I found it a matter of the most elaborate and exhausting and tedious computation. It was locomotion of a sort, but unanimal, unhuman. “This is walking?” I said to myself, and then, with a qualm of terror: “Is this what I will have to put up with for the rest of my life? Will I never get back the feel of true walking? Will I never again know a walking which is natural, spontaneous, and free? Will I be forced, from now on, to think out each move? Must everything be so complex—can’t it be simple?”

  And suddenly—into the silence, the silent twittering of motionless frozen images—came music, glorious music, Mendelssohn, fortissimo! Joy, life, intoxicating movement! And, as suddenly, without thinking, without intending whatever, I found myself walking, easily, joyfully, with the music. And, as suddenly, in the moment that this inner music started, the Mendelssohn which had been summoned and hallucinated by my soul, and in the very moment that my “motor” music, my kinetic melody, my walking, came back—in this self-same moment the leg came back. Suddenly, with no warning, no transition whatever, the leg felt alive, and real, and mine, its moment of actualization precisely consonant with the spontaneous quickening, walking and music. I was just turning back from the corridor to my room—when out of the blue this miracle occurred—the music, the walking, the actualization, all one. And now, as suddenly, I was absolutely certain—I believed in my leg, I knew how to walk.

  I said to the physiotherapists: “Something extraordinary has just occurred. I can walk now. Let me go—but you had better stand by!”

  And walk I did—despite weakness, despite the cast, despite crutches, despite everything—easily, automatically, spontaneously, melodiously, with a return of my own personal melody, which was somehow elicited by, and attuned to, the Mendelssohnian melody.

  I walked with style—with a style which was inimitably my own. Those who saw this echoed my own feelings. They said: “You walked mechanically, like a robot before—now you walk like a person—like yourself, in fact.”

  It was as if I suddenly remembered how to walk—indeed, not “as if.” I remembered how to walk. All of a sudden I remembered walking’s natural, unconscious rhythm and melody; it came to me, suddenly, like remembering a once-familiar but long-forgotten tune, and it came hand in hand with the Mendelssohn rhythm and tune. There was an abrupt and absolute leap at this moment—not a process, not a transition, but a transilience—from the awkward, artificial, mechanical walking, of which every step had to be consciously counted, projected, and undertaken—to an unconscious, natural-graceful, musical movement.

  Again I thought instantly of Zazetsky, in The Man with a Shattered World, and his turning point, as recounted by Luria—the sudden discovery he made one day, that writing, previously desperately difficult, as he agonized over each letter and stroke, could become perfectly simple if he let himself go, if he gave himself, unconsciously and unreservedly, to its natural flow, melody, spontaneity. And then I thought of countless, though less spectacular, experiences of my own—times when I had set out to run or swim, first counting and calculating each step or stroke consciously, and then, quite suddenly, discovering that I had got into it, that I had, mysteriously, without in the least trying, got into the rhythm, into the feel, of the activity, and that now I was doing it perfectly and easily, with no conscious counting or calculation whatever, but simply giving myself to the activity’s own tempo, pulsion and rhythm. The experience was so common I had hardly given it a thought, but now, I suddenly realized, the experience was fundamental.

  Had I had any thought that the coincidence of ambulation and actualization with the Mendelssohn was a freak—a mere coincidence, of no special significance—the idea was to be dissipated forty seconds later, when, striding along, full of confidence, I had a sudden and unexpected relapse—suddenly forgot my kinetic melody, forgot how to walk. In this moment, as suddenly as if the needle had been lifted from a record, the inner playing of the Mendelssohn stopped, and in the instant it stopped my walking stopped too. Suddenly the leg ceased to be stable and real and reverted to its cinematic delirium, its awful wild jumping of shapes, sizes, frames. As soon as the internal music stopped, the walking stopped too, and the leg was de-actualized into fluttering phantoms. How could I doubt the significance of all this? The music, the action, the reality were all one.

  I was helpless, once again, and could hardly stand.

  The two physiotherapists guided me to a rail, which I grabbed and held on to with all my strength.

  The left leg flopped nervelessly. I touched it, and it was toneless, unreal.

  “Don’t worry,” said one of them. “It’s local fatigue. Give the nerve terminals a little rest, and it’ll come right again.”

  Half-propped against the rail, half-standing on my good leg, I rested the left leg. The delirium diminished, the excursions grew less wild, though fluttering at the same rate. After two minutes or so, there was sufficient stability. With my supporters, I ventured forth again. And now, for the second time, the music came back, as suddenly as at first, and with its return there came back spontaneous, joyous, thoughtless walking, and tone and actuality to the leg. Luckily it was only a few yards to my room and I was able to retain the music, and musicality, of motion, until I had gained my chair and, from this, my bed, exhausted but triumphant.

  In bed I was ecstatic. A miracle seemed to have happened. The reality of my leg, and the power to stand and walk again, had been given to me, had descended upon me like grace. Now, re-united with my leg—with a part of myself that had been excommunicated, in limbo—I found myself full of tender regard for it, and stroked the cast. I felt an immense feeling of welcome for the lost leg, now returned. The leg had come home, to its home, to me. In action the body had been broken, and only now, with the return of bodily action as a whole, did the body itself again feel like a whole.

  Until the music, there had been no feeling whatever—that is, no essential feeling in the phenomena themselves. This was especially clear in the fantastic few minutes of kaleidoscopic, flashing vision. It was spectacular, the most spectacular display I had ever seen in my life; but it was only a spectacle, and I only a spectator. There was no entering, nor any thought or possibility of entering, these purely sensorial and intellectual phenomena. One gazed at them as one would gaze at fireworks, or the sky. They could be seen as having a cold and impersonal beauty, the beauty of mathematics, of astronomy, the sky.

  Then, all of a sudden, with no warning whatever, into the cold starry impersonal cosmos—the equally cold and impersonal micro-cosmo
s of the mind—came music, warm, vivid, alive, moving, personal.

  * * *

  —

  Music, as I had dreamed at the weekend, was a divine message and messenger of life. It was quintessentially quick—“the quickening art,” as Kant had called it—quickening my soul, and with this my body, so that suddenly, spontaneously, I was quickened into motion, my own perceptual and kinetic melody, quickened into life by the inner life of music. And in that moment, when the body became action, the leg, the flesh became quick and alive, the flesh became music, incarnate solid music. All of me, body and soul, became music in that moment:

  You are the music

  while the music lasts.

  —T. S. ELIOT

  Everything was transformed, absolutely, in that moment, in that leap from a cold fluttering and flashing to the warm stream of music, the stream of action, the stream of life. The delirium, the pandemonium, the kaleidoscope, the cinema—this was essentially inanimate, discontinuous; whereas the stream of music, of action, of life, was essentially, and entirely, and indivisibly, a stream, an organic whole, without any separations or seams, but articulate, articulated, articulate with life. An entirely new principle came into effect—what Leibniz called a “new active principle of unity”—a unity only present in, and given by, action.

  What was so wonderful was the heavenly ease and sureness—I knew what to do, I knew what came next, I was carried ahead by the ongoing musical stream, without any conscious thought or calculation, carried ahead by the feeling of it all. And it was this that was so different, so absolutely different, from the elaborate and exhausting computation before—the sense that everything had to be counted and worked out beforehand, to be worked out as programs, strategies, procedures, and that nothing could be simply, thoughtlessly, done. The joy of sheer doing—its beauty, its simplicity—was a revelation: it was the easiest, most natural thing in the world—and yet beyond the most complex of calculations and programs. Here, in doing, one achieved certainty with one swoop, by a grace which bypassed the most complex mathematics, or perhaps embedded and then transcended them. Now, simply, everything felt right, everything was right, with no effort, but with an integral sense of ease—and delight.

  What was it, then, that came suddenly back—embodied in music, glorious music, Mendelssohn, fortissimo? It was the triumphal return of the quintessential living “I,” lost for two weeks in the abyss, and two minutes in the delirium; not the ghostly, cogitating, solipsistic “I” of Descartes, which never feels, never acts, is not, and does nothing; not this, this impotence, this mentalistic fiction. What came, what announced itself, so palpably, so gloriously, was a full-bodied vital feeling and action, originating from an aboriginal, commanding, willing, “I.” The phantasmagoria, the delirium, had no organization, no center. What appeared with the music was organization and center, and the organization and center of all action was an agency, an “I.” What appeared in this moment transcended the physical, but instantly organized and reorganized it into a seamless perfect whole. This new, hyper-physical principle was Grace. Grace, unbidden, appeared on the scene, became its center, transformed the scene. Grace entered, at the very center of things, at its hidden innermost inaccessible center, and instantly co-ordinated, subordinated, all phenomena to itself. It made the next move obvious, certain, natural. Grace was the prerequisite and essence of all doing.

  Solvitur ambulando: the solution to the problem of walking is—walking. The only way to do it is—to do it. Here action and thought reached their end and repose. I had had the most eventful and crucial ten minutes of my life.

  CHAPTER SIX

  Convalescence

  Gratitude pours forth continually, as if the unexpected had just happened—the gratitude of a convalescent—for convalescence was unexpected…[One] is now all at once attacked by hope,…the intoxication of convalescence…after long privation and powerlessness, the rejoicing of a strength that is returning, of a reawakened faith in a tomorrow and the day after tomorrow, of a sudden sense and anticipation of a future, of impending adventures, of seas that are open again, of goals that are permitted again, believed again.

  —FRIEDRICH NIETZSCHE

  Freedom! Now, suddenly, I could walk, I was free. Now, suddenly, I was whole, I was well. At least I could feel what wholeness, wellness, felt like, where they had been unimaginable—beyond thought, beyond hope—before. Now, suddenly, walking, I knew again a physical or animal freedom—prelude, perhaps, to any other freedom. Now, suddenly, vistas opened up—where, hardly realizing it, I had seen nothing before. I had lain or sat, virtually motionless, as if paralyzed, for eighteen days in my room, eighteen days of intense thought, but without doing or going. I was not free, physically free, to do or go. But now I could, as by a miracle, stand; and simply by standing, being able to stand, my “standing,” in all respects, was radically changed.

  In the moments of first standing and walking—or, more accurately, the moment that immediately followed—I found I felt completely different: no longer prostrate, passive-dependent, like a patient, but active, erect, able to face a new world—a real world, a world now made possible, instead of the shifting half-world of patienthood and confinement I had been in. I could stand up, step forward, go from and to—from confinement and patienthood to a real world, a real self, whose very existence, incredibly, and ominously, I had half forgotten. Stewing in confinement, passivity, immobility: stewing in the depths of scotoma and despair; stewing in the darkness of interminable night, I had forgotten, could no longer imagine, what daylight felt like.

  Back in my room, on my bed, I hugged the redeemed leg, or rather cast, though even this seemed living now, transfused with the life of the leg. “You dear old thing, you sweet thing,” I found myself saying. “You’ve come back, you’re real, you’re part of me now.” Its reality, its presence, its dearness, were all one. I gazed at it in a sort of bliss, filled with the sense of intense physicality, but a physicality radiant and almost supernatural—no longer an uncanny, ghastly-ghostly dough, but “the holy and glorious flesh” restored. I felt aflame with amazement, gratitude, joy.

  I had tried and tried for at least fourteen days, to think the leg back into life and reality—utterly useless efforts, as vain as they were strenuous. And now, without thinking, without trying, the leg was there—wondrously, unassailably, gloriously there. It seemed radiant in its overwhelming and immediate thereness—that thereness now given, which no thinking could reach. (Not passively, but actively there—its thereness, its presence, being one with potential: a thing of power now, bodied power, which I could move as I wished.)

  For 300 hours, motionless, in my room, on my bed, I had lain still, and thought. One “stops to think,” one is arrested by thought; and being stopped, being arrested, in my senses and body, removed from doing, I was forced into thinking. Now the time for thinking was over, and the time for doing had come; now—and for the weeks ahead—my flight would be swift, intuitive, unreflective; I would return to my body, my being, the world, to the special adventure of convalescence and rebirth; I was to come alive again, and know life, as never before.

  On the succeeding days my walking was much better. It came daily more easily, more fluently, more musically, although with fatigue I would fall back into “delirium”—flashing images without inner sense or motion. But with each walk, and each day, I found myself stronger, and able to walk further before delirium set in. It occurred, for the last time, about a month after surgery, after I had walked for miles in the great grounds of the Convalescent Home in Caenwood. I have never known the experience since.

  With each succeeding day, each success, I grew bolder—overbold—and had to be held back from “overdoing” it, pushing the leg, if not to delirium, to swelling and strain. The return of health and strength—convalescence—was intoxicating, and I continually misjudged what I could or should do; and yet it wasn’t smooth, it consisted
of steps—with no spontaneous advancement from one stage, or one step, to another. When I stole a look at my chart and saw “Uneventful Recovery,” I thought: “They’re mad. Recovery is events, a series of wonderful, unpredictable events: recovery is events, or rather advents—the advent of new and unimaginable powers—events, advents, which are births or rebirths.”

  Recovery was not to be seen as a smooth slope, but as a series of radical steps, each inconceivable, impossible, from the step below. And, by the same token, one could have not even hope. One could hope for an increase of whatever one had, but one could not hope, in the least, for the unimaginable next step (for hope implies some degree of imagining). Thus every step had the quality of miracle—and might never occur without the urging of others.

  With each step, each advance, one’s horizons expanded, one stepped out of a contracted world—a world one hadn’t realized was so contracted. I found this in every sphere, physiological and existential. One example comes specially to mind: three days after my first walk, I was moved into a new room, a new spacious room, after twenty days in my tiny cell. I was settling myself, with delight, when I suddenly noticed something most strange. Everything close to me had its proper solidity, spaciousness, depth—but everything farther away was totally flat. Beyond my open door was the door of the ward opposite; beyond this a patient seated in a wheelchair; beyond him, on the windowsill, a vase of flowers; and beyond this, over the road, the gabled windows of the house opposite—and all this, two hundred feet perhaps, was flat as a pancake, and seemed to lie like a giant Kodachrome in the air, exquisitely colored and detailed, but perfectly flat. I have very good depth perception and I suddenly realized that something had happened to my sense of depth and stereoscopy, that it stopped, quite suddenly, a few feet in front of me—that I was still enclosed, visually, in a transparent box, about nine by seven by six feet, the precise size of the “cell” I had occupied for twenty days. I was still in this, perceptually, despite being moved—still in a grossly restricted visual space with perfect stereoscopy to its limits, and no trace of it beyond. It was a bizarre experience, which fascinated (without frightening) me—for it was not charged, like the leg, with terrible trauma and fear. I could observe, even measure, the parallactic displacements which are normally seen as “depth,” but noting this, knowing this, did not restore depth. Depth, stereoscopy, returned in jumps, like the jerky opening-out of a visual concertina, over a period of about two hours; and even then it was not complete, for turning over in bed and gazing out of the window—bliss! I had been windowless, vistaless, for twenty days—I could see, as though through the wrong end of a telescope, the tiny gem-like hospital garden, but absolutely flat, and with its angles all wrong, looking distorted, trapezoidal, when it was, obviously, a square. And I had now to gaze at this, beyond my previous far-point, until its distance and depth and appearance jumped right.