
Oliver Sacks on learning he has terminal cancer - the_duck
http://www.nytimes.com/2015/02/19/opinion/oliver-sacks-on-learning-he-has-terminal-cancer.html
======
sswaner
Many years ago, as a young undergrad, I ambushed Oliver Sacks right after he
finished addressing a Music Therapy conference. I asked if I could run an idea
by him, he said we could talk while he walked to his car. I explained my
hypothesis of a potential cause of neurodegenerative diseases. He listened
patiently then said "I have similar thoughts, the challenge is proving it".
Then, just before stepping into his car, he said "If you are right, and can
prove it, you would win the Nobel Prize. Good luck, young man." I doubt he
remembers this conversation, but for me it was an amazing experience I will
never forget. The lab I worked in wasn't equipped to study the idea, and I
became the lab computer guy instead of a neuroscientist. But I am still
grateful to the confidence given me in that short conversation.

~~~
sixQuarks
I was hoping you were going to end the comment with something like "... and I
am happy to say I went on to win a Nobel prize"

~~~
drzaiusapelord
I wonder if HN has any Nobel lurkers.

~~~
Mahn
I doubt Nobel Prize winners procrastinate on HN as much as we do. They are
probably busy making things happen.

~~~
larrys
I think of Nobel Prize winners as what I will call "single function machines".
That is, and this is purely speculative, they are focused on only typically
one goal or area of interest maniacally.

The typical HN reader, by contrast, finds many things and almost everything
and anything (as PG might say) interesting. [1]

"If you had to reduce it to a sentence, the answer might be: anything that
gratifies one's intellectual curiosity. "

This is not to say that Nobel Prize winners aren't curious of course they are.
But somehow I doubt they are all over the place. I find so many things
interesting it's hard for me to stay focused some times with the distractions
of what is available at your fingertips.

[1]
[https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html)

~~~
benbreen
Not sure if I agree with this (Linus Pauling comes to mind), but speaking
anecdotally, I once had breakfast with a recent winner of a MacArthur grant
(the so-called Genius Grant) expecting to be the recipient of untold wisdom.
Instead he gave me a blow by blow explanation of the delayed burial of William
the Conqueror, his pet topic. Seemingly unconcerned that describing a dead
king's corpse exploding wasn't great breakfast conversation.

~~~
nocman
Perhaps he grew up on a farm. :-D

That kind of discussion (and much worse) often occurs at the breakfast table
on many farms without anyone ever batting an eye.

~~~
HeyLaughingBoy
Typing this while scarfing down a burrito....

For example "hey, do you know what kind of animal that foot on the front steps
is from? There's a blood trail behind it but the cats aren't very interested."

------
dr_
Anyone who is even remotely interested in end of life issues, and anyone who
is a physician, should really read Atul Gawandes Being Mortal. Many people are
unable to live their lives out the way Dr Sacks hopes to, simply because the
medical establishment as is doesn't really allow for it. The best takeaway
from this essay is that, in the end, you have to focus entirely on things that
matter to you most. But you should also be clear on this with your treating
providers - so at the end you are spending time with your loved ones, and not
going in and out of the hospital.

~~~
jeffreyrogers
> because the medical establishment as is doesn't really allow for it.

I have many relatives and friends in medicine. They will let you end your life
the way you want to (for the most part) but you have to be firm about what you
want. Doctors don't like telling people they're dying because it is a hard
conversation to have. And most people, even those who are aware of the
statistics, like to cling to the hope that they could be different.

~~~
sukilot
Thatse why it is important to know that, statistically, hospice provides
better and longer life than aggressive treatment of advanced cancer. Hospice
patience enjoy more hours of non-treatment "real life" than agressive-care
patients (who spend far more time in hospital beds or surgery instead of
outside, with family, Etc)

------
avz
"I have been a sentient being, a thinking animal, on this beautiful planet,
and that in itself has been an enormous privilege and adventure."

Beautiful.

~~~
geoffsanders
This is one of the most honest and genuine observations I've ever heard; an
observation that one can likely only fully appreciate in the face of
mortality.

Beautiful, indeed.

------
tpopp
Please, if anyone else reading this has the same cancer, do not listen to any
medical professional saying to lay back and die. Sacks was, lucky if it can be
called that, to have the less aggressive strain of Ocular Melanoma that
metastasized. The most aggressive usually results in death in 18 months, but
there is progress being made to extend this to 4 years. Look up Dr Sato of
Thomas Jefferson. He's the expert on this cancer. Your loved ones will be
extremely grateful for an extra 2 years with you, and the best treatments
barely degrade the quality of your life at all.

~~~
MagicWishMonkey
Eeking out an extra (potential) 2 years in exchange for the mental and
physical torture of chemotherapy is not worthwhile for some people,
particularly the elderly.

~~~
tpopp
Chemotherapy does not work on this type of cancer. The best treatments, with
the exception of one semi-annual treatment, give 2 days of fatigue and that's
about it. The physical torture is not there, only the mental torture of having
a terminal illness. Additionally, this cancer does not cause your health to
degrade until the very end.

You're right about it depending on the person though. There is just a lot of
misconception about this particular cancer, which is why I commented about it.

------
jgrahamc
If you are reading that and discovering Oliver Sacks for the first time, or
just haven't read any of his books, may I recommend that you get a copy of
Uncle Tungsten? It's wonderful memoir of growing up in London and a history of
chemistry.

~~~
MartinCron
May I recommend that you just read everything. Maybe I'm just a grief-stricken
fan, but I'm pretty sure that Oliver Sacks hasn't written a sup-bar or un-
interesting sentence in his entire life.

~~~
ddoolin
sub-par*? -- I find that I actually pronounce it like you spelled it somewhat
often.

~~~
MartinCron
You have to point it out after it is too late to edit... Sigh

------
edw519
_I feel intensely alive, and I want and hope in the time that remains to
deepen my friendships, to say farewell to those I love, to write more, to
travel if I have the strength, to achieve new levels of understanding and
insight...I feel a sudden clear focus and perspective. There is no time for
anything inessential. I must focus on myself, my work and my friends. I shall
no longer look at “NewsHour” every night. I shall no longer pay any attention
to politics or arguments about global warming._

Great advice for everyone. We are all dying. The magnitude of our vectors may
be different, but the direction is always the same.

------
JacobAldridge
The first book I ever bought the woman who became my beautiful wife was
Sacks's _The Man who Mistook his Wife for a Hat_. She had mentioned enjoying
some Psychology studies, so it seemed relevant.

His writing then, as now, leaps off the page and dances with your mind. Sadly,
we will soon lose any possible new writing, and joyously he leaves a lifetime
of work as a legacy.

~~~
MarkMc
_The Man who Mistook his Wife for a Hat_ is such a wonderful book - perhaps my
favourite. The characters and ailments of each case are fascinating, but it's
Sacks' empathy and understanding that really makes the books special.

Every few pages I would stop reading, stare into space and contemplate the
unusual perspective that he has elucidated. Not many books have such an
effect.

If you haven't read _The Man who Mistook his Wife for a Hat_ , please add it
to the top of your list.

------
Jolijn
I should write a note for my wife and children in case an accident happens, so
I can express to them how happy a life I've had with them, even if I died
before realizing my dreams.

~~~
tomjen3
Better yet: record a video. It will be more personal than just a note.

Also you mentioned your children being young. You may want to record videos
for their various birthdays and other life events in case you are no longer
alive. I know I will do this when/if I have any children.

~~~
philh
I vaguely recall a reddit comment recommending against that. It was along the
lines of: The commenter knew someone whose father had done it, and the
commenter thought that it made it a lot harder for that person to move on.
Every year, on their birthday, they'd receive a fresh wound from someone they
never even knew.

~~~
bentcorner
You can't opt-in to this sort of thing, I'd rather spend the time with
videos/notes and have my loved ones choose to opt-out if they had enough.

What you say does have merit though - I would make it very clear that they
would be under no obligation to "reopen the wounds", as it were.

~~~
tach4n
Is it really a choice though? I imagine most people would feel a fairly strong
obligation to watch the video if they were told it was recorded as, say, a
birthday present for them. The temptation would be very strong at least, and
difficult for many to resist. I suppose after a few miserable experiences with
it, some might be able to put the box of tapes away forever - but then they'd
probably always carry some guilt.

I think it's better to do what one of my best friends (inadvertently) did when
they died young - leave a good legacy of mementos for their loved ones. I, for
my part, have a collection of musical recordings we made together that I can
pull out when I feel like it. It's incredibly emotionally difficult to listen
to (especially the parts where the tape was running between songs) but it
helps at times. His girlfriend of the time has a lot of his writings/journals
she can read to remember his thoughts on life or incidents that happened.

If you know ahead of time, record some memoirs and thoughts. Perhaps build
something for them. Give a general message to your loved ones that you had a
happy life, etc - whatever seems suitable for the situation and people
involved.

...but the idea of recording "A message for my daughter on her 6th birthday
from beyond the grave" is incredibly macabre to me and I personally would not
want that.

There's much risk involved as well for the tiny little "cuteness" of the fact
that the videos were recorded for specific life events. I for one wouldn't
want to listen to a deceased parent go on about how proud they were I found a
husband on my wedding day to my new wife for example. Or have to spend my
whole life staring at a tape marked "for your wedding" and never watching it.

~~~
amyjess
> There's much risk involved as well for the tiny little "cuteness" of the
> fact that the videos were recorded for specific life events. I for one
> wouldn't want to listen to a deceased parent go on about how proud they were
> I found a husband on my wedding day to my new wife for example. Or have to
> spend my whole life staring at a tape marked "for your wedding" and never
> watching it.

Expanding on this, I'm transgender, and I really wouldn't want to be
repeatedly deadnamed on my birthday.

------
300bps
_I have been increasingly conscious, for the last 10 years or so, of deaths
among my contemporaries._

I am about half the age of Oliver Sacks. In the past year I've gone to two
funerals for people younger than I am. It's a very poignant reminder of your
own mortality when people your age or younger pass away.

------
CartyBoston
It's a beautiful essay, and I don't mean to undermine its gravity but one
thing he mentioned has me curious. How does one conclude that two tumors are
related? Might it be that the cancer that metastasized in his liver is
independent of that that was in his eye?

He _is_ a neurologist, I am not intending to challenge, just curious and I
know there are people here that know much more than I do.

~~~
copperx
I'm guessing they did a biopsy of the tumor in the liver and found it was
ocular melanoma. Elementary, my dear Watson.

~~~
CartyBoston
That was my first post here, I want to watch my step.

Is an "ocular melanoma" any tumor discovered in the eye? Or is it mutated eye
tissue that was subsequently discovered in his liver? Which would indeed be
pretty definitive.

I do appreciate your help.

~~~
karmajunkie
Melanoma in the eye is most commonly of a type called uveal melanoma. Ocular
melanoma would be any melanoma in the eye, including the more common skin
types (e.g. nodular, or superficial spreading, which is the most common
subtype) which metastasized to the eye (very rare). Uveal melanoma confounds
most of the effective melanoma treatments to date, even the most current and
exciting treatments that have come on the market in the last few years. The
reason (rather, _one_ reason) is that it shares few of the same genetic
targets that the more common subtypes have.

A primary tumor which metastasizes elsewhere in the body has characteristics
of the primary tumor, including genetic markers, which is what allows a
pathologist to determine a likely origin.

------
jpdoherty
Absolute poetry. I hope I face life with that kind of love, dignity, and open
embrace when I'm in my final years.

~~~
kristofferR
Why not now?

------
ahussain
This article reminds me of an incredibly beautiful one by Christopher Hitchens
called "Unspoken Truths"

[http://www.vanityfair.com/news/2011/06/christopher-
hitchens-...](http://www.vanityfair.com/news/2011/06/christopher-hitchens-
unspoken-truths-201106)

------
gmisra
This seems like a perfect opportunity to share some more reflections on death
from those who are often closest to it, doctors themselves. It appears that
many (most?) doctors choose to spend their final days differently than most of
their patients.

[http://www.zocalopublicsquare.org/2011/11/30/how-doctors-
die...](http://www.zocalopublicsquare.org/2011/11/30/how-doctors-
die/ideas/nexus/)

[http://www.nytimes.com/2013/11/20/your-money/how-doctors-
die...](http://www.nytimes.com/2013/11/20/your-money/how-doctors-die.html)

------
guruparan18
Anything that is related to death and uncertainty in general kindles lot of
thought in one's mind. I for one, have always considered it to be a great
interest to read about them. Here is a prose, written roughly 2000 years ago,
dealing with death. It compares death to a sinking ship in a calm deserted
ocean (contrast to violent shipwreck). Death engulfs the old ship very slowly.

Translation: The bonds of friendship are broken, friends, relatives and wive
have become cold in love, or few, the cords of love are loosened. Consider the
matter well. What profit is there in the attached state? Oh, it is come, the
wail of distress, as when a ship founders!

See:
[http://www.tamilvu.org/library/l2800/html/l2800ind.htm](http://www.tamilvu.org/library/l2800/html/l2800ind.htm)
for original text.

------
ProAm
> This is not indifference but detachment — I still care deeply about the
> Middle East, about global warming, about growing inequality, but these are
> no longer my business; they belong to the future.

This quote sticks out to me, I feel everyone acts, by and large, like this
towards these issues (or most issues) regardless of age or health. Probably my
pessimistic view of the world, very interesting to read from him.

------
jusben1369
What, if any, relevance to readers here place on the fact that he is 81 vs 61
or 41, to his overall generally positive state of mind?

~~~
bshimmin
81 is a reasonably good innings, slightly above the average for the US, and
just about the average for the UK (Sacks is British-American, I believe) - one
wouldn't describe dying at that age as a particularly early or premature
death.

I think it's hard to separate that intrinsic fact from his stoicism on the
subject, impressive though it is. I'm sure it's not easy at any age to face
your impending demise, but knowing you've led a pretty long and very
successful life perhaps makes it an easier pill to swallow. And, to be a
little cynical, we're reading this in a column in The Gray Lady - perhaps he's
terrified on the inside but putting on a brave face for the public, either to
keep up appearances or to be a source of inspiration for others.

Seems like this would be a good day to re-watch "Awakenings"...

~~~
rvn1045
whoever has said they've led a happy life, surely hasn't faced death yet.

------
agumonkey
Rare time when death feels like an Ode to life.

------
goffley3
One of the great sages of the world soon to leave us. I love his writing and
the different perspectives that his work has offered me. He'll be missed and
as bad as this sounds I'm excited to see what writings he comes up with as he
takes the final steps of his journey.

------
WhitneyLand
Most of his reflections on how to live with terminal illness seem like a
fulfilling way to embrace life at any time. Funny how our focus has to be
retrained so often on the things we already know are the most important.

------
robotnoises
I wish I could do anything as well as Oliver Sacks writes.

~~~
alandarev
Then master yourself, you are not 81 with a terminal cancer here.

~~~
sireat
Unless you are under the age of 25(and preferably under 15) you have little
hope of mastering anything.

Once you get over 40 you realize that your best hope is to work with what you
have (that and your children).

You are not going to learn a new skill sufficiently well to be called master
in it.

Sorry, if you start medical school at 40 you are not going to be performing
brain surgery at 50.

If you did no writing from 18 until 40 you are not going to suddenly master
writing.

Counterexamples welcome.

Whenever, I find someone who did something exceptional at a later life, I find
someone who actually laid a solid foundation in his/her teen years.

"I want more life father"

~~~
sergiosgc
Counterexamples:

\- Vincent Van Gogh: Never painted anything until he was 27

\- Dave McClure: Angel investor, who did not invest in anything until he was
40

\- Fauja Singh: Marathonist, who though marathons were 26km until he was 89(!)

\- Joseph Conrad: Successful writer at 39, he learned English in his twenties.

\- Stallone: If you discount soft porn star roles, he started acting in his
mid twenties (ok, I concede this one, Stallone is not the ultimate actor :-P )

Naturally, these are anecdotal. But you should reconsider your hypothesis, and
test for sample deviation. Naturally, most people will stick to what they are
good at. Only a fraction will go out of their comfort zone. You must account
for this bias.

If your hypothesis is that most people won't master anything new later in
life, you are probably correct. If your hypothesis is that, out of those
people who try to master something new later in life, most won't succeed, I
believe you are wrong. You are falling prey to a wrong sample selection.

Out of those people who have put out the time, around me I see very good
success rates. For a decent experiment, check out Ben Larcombe's table tennis
expert in a year experiment: [http://www.experttabletennis.com/expert-in-a-
year/](http://www.experttabletennis.com/expert-in-a-year/)

While he did actually fail his goal, a look at his end of year videos makes me
label him as having mastered the art of table tennis as much as a random child
would do under training (i.e. age played no role in the result).

~~~
sireat
My apologies for not being factual enough and sounding too cynical without
providing more detail.

Appreciate the responses with actual counterexamples:

\- Van Gogh: was drawing as a child and continued to draw upon starting to
paint. This is the solid foundation that I mentioned my OP. This is even
closer than a shogi 9-dan becoming a chess master at 30.

\- Dave McClure: hit lottery(even if you argue it was skill, it has nothing to
do with my hypothesis) with Paypal, after that he has bought a lot (500+) of
lottery tickets. Nothing wrong with that but I do not see mastery (ala
Buffett) VC is a field where it is hard to measure mastery. I suppose one
could take 10 year risk adjusted returns as some measure. Again, you can start
doing anything at any age, but do not expect any great results.

\- Fauja Singh: "As a young man, Fauja was an avid amateur runner, but he gave
it up at the time of the 1947 India-Pakistan Partition." His records ar 90+
are fantastic for a 90 year old and probably 70-80 year olds but no more than
that.

\- Joseph Conrad , writers in general are a tricky to evaluate as most of us
have had "some" writing in teenage years. Surely, Conrad wrote in Polish and
French in his teen years.

One of my favorite writers Raymond Chandler did not really become a writer
until age of 44, so does he disprove my hypothesis? If you look at his bio, he
must have written/dictated quite a bit as an oil executive sober or not. Even
more importantly he was a reporter for the Daily Express and the Bristol
Western Gazette newspapers in his 20s.

\- Stallone: nothing unusual in his career, he might have started acting a few
years later than most aspiring Hollywood hopefuls. His success with Rocky does
not really dis/prove his mastery of acting. He is decent at his craft.

\- Ben Larcombe's table tennis experiment: his subject was his friend 24 year
old Sam Priestley. Again this falls within my 25 year old rule. Besides that
the experiment failed!

Actually I agree with most of the conclusions that Ben Larcombe reached:
[http://www.experttabletennis.com/possible-master-table-
tenni...](http://www.experttabletennis.com/possible-master-table-
tennis-12-months/)

However again, age is a harsh mistress and past 40 the decline in your
learning ability becomes noticable.

We all need our delusions and the "I can do anything if only I set my mind to
it" is quite a common one.

~~~
sergiosgc
We'll have to agree to disagree. In every success case, you'll find a nitpick.
Van Gogh was innovative in his use of color, a characteristic clearly
developed as an adult, and yet you dismiss it because he drew as a child.
McClure has no value because he hit the jackpot once and rode from there.
Conrad must surely have written in Polish and French (yet published nothing
and left no manuscripts), which surely undermines the excellent storytelling
abilities and remarkable prose he developed _after_ he stopped working a full
time job. A really old man can only run the marathon in over 6h, three times
the world record (I'm a third his age, and I can, maybe, do the marathon
walking and beat the 7h mark).

If you do not understand the bias I have presented, central point in my
argument that you sidestepped, at least understand this: You can choose to
believe you can do anything, or you can choose not to. There's a chance of
error in each choice. The loss in the error case, for each option, clearly
favours choosing the optimist option. Even if all your steps forward are
followed by backward steps, at least you are dancing Cha Cha, not moping your
way down to a sad grave.

------
brosky117
This was an eloquent and beautiful article that helped me to consider my own
mortality. Thanks for sharing.

------
dnetesn
Hume would have been impressed.

