Oliver Sacks once studied an elderly woman named Natasha K. Shortly after she turned eighty-eight, she told Sacks, she began to feel suddenly flirty and energetic. Natasha decided that she was “suffering” from Cupid’s Disease, a euphemism for syphilis. Natasha caught syphilis when she was younger, but had it treated with penicillin. She asked Sacks if it’s possible for the syphilis to “catch up” with her. Sacks confirmed that Natasha was afflicted with a rare case of cerebral syphilis. However, Natasha told Sacks that she didn’t want him to treat her syphilis—she liked the way it made her feel. Sacks writes, “our course, mercifully, was clear.” He gave Natasha penicillin, which killed the potentially deadly spirochetes in her brain, but didn’t do anything to reverse the mental changes that had already taken place.
Natasha “suffers” from a serious neurological disorder, syphilis, but she doesn’t experience the disorder as a problem of any kind, and, in fact, wants to live with her syphilis instead of letting Sacks treat it. Notice that Sacks refuses to editorialize over whether or not Natasha’s decision is reasonable. Instead he writes, “our course, mercifully, was clear,” suggesting that in this particular case he didn’t have to make a choice between preserving Natasha’s new, energetic personality and removing it (and instead just had to kill off the spirochetes).
In the Postscript, Sacks notes that he’s encountered a similar dilemma in a patient named Miguel O., who suffered from a kind of neurosyphilis that made him especially manic. Sacks gave Miguel drawing tests designed to measure his sense-perception. Instead of duplicating the drawings that Sacks gave him, Miguel preferred to elaborate upon them. But then, when Sacks treated Miguel’s symptoms with Haldol, Miguel’s drawings became duller. Miguel was sad that Haldol made him less imaginative. Sacks notes the irony: “that inner life and imagination may lie dull and dormant unless released, awakened, by an intoxication or disease!” Under the right circumstances, he says illness could be considered wellness, while normality could be considered a form of illness.
Although he pointedly doesn’t take a position on whether or not Natasha’s syphilitic personality was “good” or “bad” (and perhaps doesn’t regard this as any of his business), Sacks goes so far as to suggest that Miguel O.’s syphilis could be construed as a form of wellness, since it excites his imagination and gives him great pleasure. Sacks’s opinions remind us that he’s not just writing a book about neurology; he’s also writing about the moral and philosophical implications of treating disease—questions that arguably lie beyond the bounds of science.