A Man Should Know His Own Leg

Oliver Sacks’ A Leg To Stand On is my favorite of his books, which is saying something: I like it better than his wonderful biography On the Move, and better than his many collections of narrative essays. A Leg To Stand On is a philosophical memoir-novel, based on his own experience and with himself as the main character.

Sacks went to a Norwegian village on vacation and chose to climb a nearby mountain. Near the top he ran into a bull and, while attempting to flee, fell over a cliff and gruesomely broke his leg. The first part of the book tells a man versus nature story, about trying to inch back down the mountain, scrabbling on his butt like a crab with a wounded pincer, increasingly convinced that he wouldn’t make it, night would fall, and he would freeze to death.

Most of the book is about what happens after he’s rescued, but the gripping early chapter already displays the book’s best features: a narrative style of surpassing clarity and readability, intermixed with reflections of quite astonishing philosophical penetration and literary scope.


Sacks has a very cultured near-death experience: he motivates himself by quoting Goethe and Nietzsche and he plays Mozart in his mind as a soundtrack to his wounded exertions. If we can assume that much of the book is a faithful record of the sort of thing that actually went through his mind—and having read his autobiography and numerous recollections of him, I think we can assume that—then A Leg To Stand On shows, among other things, the incredible internal richness that bildung, the lifelong process of thirsty cultural self-shaping, can lend a life. John Stuart Mill famously defends the pleasures of high culture by saying that anyone who has experienced both vulgar pleasures and more refined ones will know the latter possess more value, more intensity and quality as pleasures. This can be difficult to prove to anyone, since everyone assumes their cognizance of pleasures, high and low, is sufficient for such judgments, and few agree about the superiority of high culture; but reading Oliver Sacks describe himself creeping down a mountain like a wounded animal stirs up, in me at least, a desire to have the kind of internal life he displays. It feels like an affective proof-by-novel of Mill’s claim.

The real plot of the book only begins after Sacks’s operation to fix the leg. He wakes up from the anaesthesia to discover that his leg has disappeared. It’s still there, visibly attached to his body, solid and available within its cast for him to wrap with his knuckles or knead with his fingertips. But it’s a foreign object, disconnected from his proprioceptive internal map, and it feels like inert meat distressingly connected to his self-sufficient trunk.

Such a syndrome was first described in the last century by Anton and is occasionally referred to as “Anton’s Syndrome,” though he only picked out a few of its features. More had been delineated by the great French neurologist Babinski, who had coined the term “anosognosia” for the singular unawareness that characterized such patients.

It turns out this anosognosia is a rather common experience for the victims of the kind of injuries that require a limb to be immobilized for a long period of time. Actually, most of us have experienced in at least the minor form of sleeping on an arm and waking up to find it, like a foreign object, weirdly insensible and immobilized until it prickles back to life.

Sacks experiences his injury not just as a stressful physical manifestation. It also sets in train a series of reflections, about identity, knowledge, even the history of philosophy:

Johnson and Wittgenstein were in perfect agreement: one existed, and could show it, because one acted—because one could lift, or kick, a stone. I suddenly thought: a man with a phantom—a phantom leg—could not kick a stone.

The story—which never ceases to be a story—becomes a meditation upon the implications of the neurology of body-image for epistemology, metaphysics, even aesthetics. I found myself looking up every few pages to reflect and frequently I was sent scurrying for a notebook.

With all the satisfactions of a plotted climax, the leg comes back to life in a most surprising and wonderful way:

And suddenly—into the silence, the silent twittering of motionless frozen images—came music, glorious music, Mendelssohn, fortissimo! Joy, life, intoxicating movement! And, as suddenly, without thinking, without intending whatever, I found myself walking, easily, joyfully, with the music. And, as suddenly, in the moment that this inner music started, the Mendelssohn which had been summoned and hallucinated by my soul, and in the very moment that my “motor” music, my kinetic melody, my walking, came back—in this self-same moment the leg came back. Suddenly, with no warning, no transition whatever, the leg felt alive, and real, and mine, its moment of actualization precisely consonant with the spontaneous quickening, walking and music. I was just turning back from the corridor to my room—when out of the blue this miracle occurred—the music, the walking, the actualization, all one. And now, as suddenly, I was absolutely certain—I believed in my leg, I knew how to walk.

A Dance With Three Legs, by Magritte

This is an incredible book, perhaps—in my opinion—the best Sacks ever wrote. Strangely, it stands rather low in the poll of popular opinion, decisively beaten out by blockbusters like Awakenings and The Man Who Mistook His Wife For a Hat. But I think the book may have a greater claim to being a major work of literature than anything else he wrote. (Admittedly, I haven’t read everything he wrote yet, so my assessment is heuristic.) Sacks’ writes brilliantly on the features of his experience common to us all, here for example on what it feels like to recover from serious infirmity:

From this moment there was no stopping me. I went out constantly, I fell in love with the world, I chartered taxis as extravagantly as a potentate visiting from another land. And, in a sense, this is what I felt like—a man, a king, long exiled, returning, accorded a wonderful, royal welcome by the world he was returning to. I wanted to hug familiar dear buildings; I wanted to hug chance strangers in the street—to hug them, devour them, like my first meal in the teashop—for they too were part of the wonderful feast. I must have smiled and laughed a great deal, or otherwise exuded happiness and love, because I received a great deal in return. I felt this especially in the pubs around Hampstead—wonderful, jolly, crowded pubs, with gardens and awnings bright in the warm sun, and people the most genial and congenial in the world. My crutches (for I needed both, to get in and out of taxis), my cast, served as a passport of universal validity. I was welcomed, I was made much of, wherever I went. And I loved it, I who had been so withdrawn and so shy. I found myself singing, playing darts, telling bawdy stories, laughing. Everywhere, and in myself, I discovered a Rabelaisian gusto—a coarse, but festive, and perfectly chaste gusto. But also, and equally, I sought for the byways of life, quiet glades, moonlit walks, for meditation. I wanted to give thanks, in every mode—in energy, in quietude; in company, alone; with friends, with strangers; in action, in thought. The joy of this time was extraordinarily intense—but it seemed to me a healthy joy, without mania or sickness. I felt that this was how one should find the world—how the world really was, if one were not jaded or tarnished. I felt the gaiety and innocence of the newborn. And if this was “the truth,” or how things should be, how could one find the world dull? I wondered if what one normally calls “normal” was itself a sort of dullness, a deadening of sense and spirit, if not, indeed, a very closure of their doors.

But in addition to this almost definitive expression of common experience, A Leg To Stand On contains the sorts of experiences and reflections that only someone as uniquely situated as Sacks could share with us.

I happen to know that this book gave Sacks more trouble than any other. I know this from his autobiography, in which he describes the years it took him to complete the manuscrip—not because he was blocked or mentally constipated; no, Sacks’ symptoms tended in the other more—um—fluid direction. The reasonably sized, normal novel-length book that we possess had to be cut from a mountain of manuscript many times longer. I think the trouble was repayed in full, however, and perhaps the invisible excess that lies behind what we possess, is what gives the book its feeling of infinity, the feeling that its significance stretches off over the horizon in every direction, no matter how thoroughly, how comprehensively it treats of the phenomena in describes.

It case you couldn’t tell, I recommend A Leg To Stand On without reservation!