Street or Naturalistic Neurology


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It’s a marvelous chapter in Paul Theroux’s new collection of old essays on famous figures featuring Oliver Sacks, “Dr. Sacks, The Healer”, that will acquaint (or re-acquaint) you with the term “street neurology”.   The essay is a reformulation of a Theroux piece previously published in Prospect Magazine in the U.K. in 1999, which you can read in its entirety here.  Theroux writes: “Oliver’s ‘street neurology’ was something I had longed to see ever since I had read about it in ‘The Possessed’ chapter of The Man Who Mistook His Wife for a Hat. The phrase refers to the assessment of a person’s condition after observing that person in a casual setting—the street, a bus, a movie line, a room full of strangers.  Among the many antecedents of ‘street neurology’, Oliver said, was James Parkinson, who delineated the disease that bears his name, not in his office, but in the teeming streets of London’ … A clinic could be scientific and helpful, but Oliver advocated a more open, naturalistic neurology.”

Theroux relates the relationship between Dr. Sacks and a young man diagnosed with Tourette’s Syndrome, Shane Fistell.  There is a three part video segment on YouTube that captures the essence of their collaboration.  In part 1, Oliver shares the background of how Gilles de la Tourette, one of Jean-Martin Charcot’s favorite students, arrived at a description of the syndrome which bears his name.

Regarding Sacks, Theroux remarks: “He is a listener of seismographic sensitivity, a clear-sighted and inspired observer, attentive, with an eloquence that allows him to describe a person’s condition, with nuance and subtlety … His patience and the tenacity of his observation makes him the most compassionate and tolerant of men, with a capacity for seeing abilities where another doctor would see only deficits.”

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It astounded me at first, when I did a search for “Sacks” on the VisionHelp blog, that there were nearly 50 entries bearing his name.  But upon reflection, it really isn’t a surprise.  A naturalistic neurology resides at the heart of what makes us who we are as clinicians.  And for that, Dr. Sacks has always been — and will remain an inspiration.

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