Inside other people's minds

The world renowned neurologist and writer Dr Oliver Sacks has revealed how personal experience of childhood abuse helped to forge his interest in mental illness.

At the age of ten, long before his interest became professional, Dr Sacks witnessed his own brother suffer from hallucinations and psychosis.

"It terrified me", he recalls, "my big brother raving and stamping and swearing."

Both boys had been abused and traumatised when they were evacuated to an oppressive school outside London during the war, he says.

Young Oliver was repeatedly beaten by a headmaster "unhinged by his own power", who once broke the cane from hitting him so hard.

While his older brother Michael reacted by becoming ill, Oliver sought refuge in chemistry and science, which formed the foundations of his career as a neurologist.

Seduction in madness

He could imagine what his brother was going through, he tells Tim Sebastian on BBC HARDtalk.

He reflects: "There is a sort of seduction about these extravagant thoughts in madness.

"For better or worse one becomes the centre of the world, the centre of every imagined blessing or curse."

His brother's ordeal gave Sacks a better understanding of what his patients were later to experience.

Minder of minds

Dr Sacks: concern and curiosity

He talks about how witnessing what goes on in other people's brains has affected him.

He describes fascinating cases: one patient who could not recognise his leg as his own, and another who had no concept of the left hand side.

This particular patient could not turn left, could not see or feel things on the left, could not understand the idea of "leftness" and was in effect living in a bisected world.

If a plate was in front of her she would eat half of the food then complain there wasn't enough.

In reacting to such cases, he says: "The feelings of comedy and horror and grief and bewilderment can all be there.

"But my first feeling is concern and curiosity."

Danger of identification

Asked whether it can be dangerous to delve into people's minds, the doctor explains:

Great sympathy can be combined with detachment

Oliver Sacks

"I will always try to imagine myself into the patient's position and to see things through their eyes.

"One part of me is objective and detached and thinks in physiological terms and the other is trying to think of what their life is like.

"I think that is necessary and not dangerous. I think great sympathy can be combined with detachment."

The danger, he says, is with identification with the patient.

This has happened to him only once: "That was dangerous and I was frightened".

Awakenings

The human brain is extremely complex

Dr Sacks is most famous for his book "Awakenings" and the hugely successful movie that followed.

"Awakenings" described how he temporarily cured patients who had been suffering from sleeping sickness, sometimes for decades, using the drug L-dopa.

The drug had been used for sufferers of Parkinson's disease - the symptoms of which are similar to sleeping sickness - but it took Dr Sacks two years to decide to use it.

The illness struck as an epidemic in 1918 and caused hundreds of sufferers to slip into paralysis.

Dr Sacks remembers first seeing the patients: "I saw people transfixed in strange positions... some had been there for decades."

Despite this, "the nurses and those who knew them were convinced that there were intact personalities and minds".

He remembers the way they suddenly regained lucidity as a "spectacular, lyrical awakening at first and embracing of life...

"I had the intensest sense of wonder I've ever had."

And he concludes: "For better or worse medicine is very personal, but above all with these patients because I was part of their lives and they were part of my life for 30 years."

Never bored

I always find something surprising, novel and adventurous

Oliver Sacks

Despite taking a "needed" holiday from his case histories and patients to write his latest book on ferns in Mexico, Dr Sacks insists he is not burned out by his work with the mentally ill.

"Burnout goes with routine", he told BBC HARDtalk.

"I always find something surprising, novel and adventurous. Even if people have the same diagnosis they respond in a different way.

"I don't get bored."

The interview can be watched in full on Friday 26 July on BBC World and BBC News 24 at the following times:

BBC News 24 (times shown in BST) 0430, repeated 2230

BBC World (times shown in GMT) 0430, repeated 0930, 1130, 1630, 1930, 0030