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Full Review
book cover
by Oliver Sacks
Book Reviews
Reviewed by David Bey, 3/30/2014

Some people get to do it for free.

Hearing voices. Seeing fantastic plays of light and color. Feeling the body transformed in impossible ways. Encounters with phantom entities. Temporary relocations of self and subjectivity. For some, experiences such as these are to be found at the bottom of a shaman’s gourd or within the crystalline lattices of the latest research chemical. For others, however, experiences like the ones above are not the result of any deliberate intervention but instead are a spontaneous consequence of the simple fact that our experience of reality is the product of our brains, and our brains are capable of being disturbed or disrupted in any number of ways.

One of today’s most prominent popular chroniclers of the brain and its remarkable vicissitudes is Dr. Oliver Sacks, who has been working and writing in the field of neurology for over forty years. His books, such as Awakenings or The Man Who Mistook His Wife for a Hat, explore case histories of patients suffering from a variety of mental disorders, documenting the effects these afflictions can have on patients’ personalities and perceptions. Sacks’ latest book, Hallucinations, addresses the remarkable transformations in consciousness and sense-experience occurring as a result of conditions such as migraines, sensory-deprivation, sleep disorders, neurological traumas, and yes, even drug use, which can serve as a remarkable “window into the organization and workings of the nervous system” (a concept that will strike most psychedelic-hip readers as being all too familiar). Some of the effects described in Hallucinations are related to medical conditions such as Parkinson’s or epilepsy, whereas some of the phantasmagoria described originate not from a specific condition, but from the brain’s own attempts to organize and correlate its contents, such as when amputees feel sensation in phantom limbs or when patients suffering from partial or total blindness or deafness will have their sensory lacunae “filled in” with the brain’s own best guesses at what might be there.

Sacks writes with an abundance of warmth and charm, and there’s a real sweetness to his descriptions of some of the happier “victims” of hallucinatory experience, such as a nice old lady with Parkinson’s who would effectively hallucinate an encounter with an attractive “gentleman caller” for a half-hour or so every evening after 8:00 pm. Indeed, it is Sacks’ stated intention that these accounts might assist in normalizing the concept of hallucination in mainstream consciousness, helping the public adjust to the idea that just because you have an experience that no one else can see or hear, that doesn’t mean that there is something so horribly wrong with you that you need to be locked up, doped up, or relegated to the social category of “damaged goods.” Implicit throughout the book is a criticism of traditional correlations between hallucinations and “madness,” as Sacks strives to demonstrate the fact that the ability to hallucinate is an inherent part of human potential.

Anyone reading this review on Erowid is probably going to be tempted to skip right to the chapter on “Altered States”, which includes Sacks’ confessional account of his own youthful fling with psychoactive exploration during his time as a medical student. Indeed, it’s a pleasure to get to see what “experience reports” are like when written by a practicing neurologist. It’s also a pleasure to get to see a public figure of Sacks’ stature own up to the role that psychedelics played in the early part of his career, even up to the point of his own “awakening” to a destiny as a writer and communicator about neurology as the result of a protracted experience reading classical medical literature while under the influence of a stiff shot of amphetamine. In the end however, it’s a little disappointing, though certainly understandable, to see Sacks sum up the wide diversity of his psychedelic experiences and file them, somewhat sheepishly and with what seems to be some reluctance, under the heading “don’t do drugs”. I suppose it must be hard to be a bestselling international author in terms of the pressure to frame such “youthful indiscretions” in the typical style of cautionary tale currently palatable to the mainstream. To be sure, it sounds like Sacks got more than a little carried away with his dosing, though it’s worth pointing out that his biggest problems were with a dependence on sedatives, rather than his flair for experimenting with psychedelics. That said, openness at even this level by a public figure is a huge step forward in the ongoing movement towards normalizing psychedelic exploration in the minds of the public. Hopefully we can all look forward to a time when a bestselling writer and scientist of Sacks’ stature can unambiguously endorse the transformative influence that psychedelics can bring to one’s life (assuming that one doesn’t fuck it up).

All in all, the experience of reading Hallucinations is full of knowing treats for the psychedelic enthusiast. Patients suffering from Charles Bonnet syndrome recount visions of ghostly figures uncannily similar to reports of ketamine-induced visions. Certain symptoms typical of Parkinson’s disease are intriguingly close to amphetamine psychosis (indeed, both are disorders of the dopamine system). The patterns and geometries of migraine auras are compared explicitly to the self-generating shapes and forms of the mescaline variety. One particularly intriguing section of the book describes those hallucinations occasioned by disturbances of the temporal lobe resulting in the experience, felt with absolute certainty, of a “presence” just out of view––a phenomenon long reported under a great variety of different psychedelic circumstance, and one made recently popular as an object of inquiry in studies involving substances like DMT. (Indeed, it’s interesting to note that, apparently, hallucinations of “discarnate entities” can be consistently induced by electrical stimulation of the temporal-parietal junction in the brain.)

Ultimately, what Hallucinations presents is something like the mainstream medical equivalent of the experience report. Connected by a certain family resemblance, both experience reports on Erowid and the kind of case studies collected by Sacks are variants within the greater manifold of knowledge derived through anecdotal accounts. And although Sacks has drawn criticism for the medical community for collecting “mere” anecdotal evidence (as opposed to conducting “serious” double-blind research), visitors to sites such as Erowid will nevertheless be perfectly familiar with the capacities of anecdotal evidence to produce empirically useful knowledge. As Sacks himself sees it, his latest book serves as:

…a sort of natural history or anthology of hallucinations, describing the experiences and impact of hallucinations on those who have had them, for the power of hallucinations is only to be understood from first-person accounts. (xiv, emphasis mine)

Here at Erowid, we couldn’t agree more.

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