1. A Leg to Stand On

In 1974 Oliver Sacks, the neurologist who has written so perceptively about the strangeness of people, had a life-threatening accident while walking alone in the mountains in Norway.  He severely injured his left leg whilst fleeing from a bull, ripping the great tendon, in which your kneecap sits, from its attachment to the top of your shin, with lots of damage to nerves.  It took him until 1984 to finish a concise account of his profound experiences in the minutes, days, weeks and years following, which was published as A Leg to Stand On.  This book is considered a classic of popular science, combining careful recording of his bodily and emotional experiences with medical, psychological and philosophical reflection and background.  It goes from torn tendon to existential crisis through a wonderfully fluent and humane self-examination. Oliver Sachs is plunged into a realm of experience beyond pain and injury and fear – he undergoes a loss of self.  This begins in the mountains when he fears he will die, there being little hope he will be found alive before nightfall.  He writes of a silence in which “I could no longer hear myself”.  In the days which follow (he is, as you will have guessed, rescued!) he recounts his loss of his sense of self, at first just through the simple experience of being horizontal.  This is significant because for many people the periods of lying down, semi-supine, are an essential part of practising the Alexander Technique.

Then comes the more familiar loss of personality and autonomy as he suffers becoming a hospital patient in a narrow room cut off from the fresh air.  The core focus of his loss, though, is his injured leg, which becomes more than, and other than, just part of himself which he cannot feel or use – it becomes something alien – a scotoma, an absence, a shadow.

The book recounts his path back to wholeness, to certainty, a path which requires his thinking and his doing to be brought together in action so that he can become again a centre of agency, an ‘I’.  It begins with this inhuman absence and can be described as passing through stages of unrecognised contraction and contortion into rediscovered space, freedom, spontaneity, grace.  More than once he has to take the unavoidable ‘first step’ which seems unimaginable until it is made or until someone helps or forces him into it.  He does get pushed into a swimming pool.  It has to do with a spirit of play, of audacity and adventure.  Gratitude for each step of his recovery is felt by him to be as necessary as the helping push.  Gratitude reconnects him to a wider world.  It expresses his own recaptured sense of self and has to be expressed towards a Being, to an other.

“Secretly, half-sceptically, hesitantly, yearningly, I addressed myself to this unimaginable ‘Thou’.” (A Leg p 82)

The medium through which Oliver Sacks finds again the active principle of unity in himself is music: recovery begins with a tape, his only tape, of Mendelssohn’s Violin Concerto which he plays again and again in the first days of his absolute sense of an aloneness sadder than death.  The music works right into the tissues of his being, wakening him to both awareness and movement, and leading him beyond concerns about how he was functioning, about muscles and nerves, flexing and extending, to realising that “without this living stream, this kinetic melody and utterance, without this being who streamed and uttered himself forth, there could be no doing, no walking, at all.” (A Leg p 167)

For the 1991 edition of the book, Oliver Sacks adds a postscript in which he retracts this conviction about a self beyond the working of the nervous system.  It had become too distant, abstract, transcendent.  To overcome that tendency, in the postscript he is content to tone down his enthusiasm, to work with the idea of a purely biological theory of consciousness, in which different levels are revealed and shown to be active in his loss and recovery.

“I repent and retract”, he says, recalling a remark by a colleague – “How come all you neurologists go mystical in the end”. (A Leg p 178)  His wish to respect the vividness, the physicality of his fundamental crisis of loss of self leads him to be wary of a ghost in the machine.  He is puzzling over the bodily experience, the bodily image, of the ‘I’.  An injury creates a void but, unusually, a void he can be aware of and which, with help, he can go through, go beyond.  This account brings out so many of the big questions I want to explore and I am grateful for the acuity and honesty of his insights.  In his researches he comes across a novel written by a neurologist in the American Civil War about a physician-patient who, as a result of amputation, has a similar experience of himself as does the physician patient Oliver Sacks.  The narrator describes his condition:  “It was, as well as I can describe it, a deficiency in the egoistic sentiment of individuality” (A Leg p 157) – a noble nineteenth century phrase to capture the nub of A Leg to Stand On.  The Alexander Technique confirms for me that there are many journeys, albeit less shocking, of divorce and discovery between ‘the egoistic sentiment of individuality’ and the firm and living connection between bone and muscle.

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