敏锐的热情:奥利佛·萨克斯《意识的河流》书评 简版
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The River of Consciousness by Oliver Sacks review – an agility of enthusiasms心理学空间`Aw9z vmg]5W/}$C

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;Bn,]X1s,E0奥利佛·萨克斯《意识的河流》书评
SU$|!jhcZW0Gavin Francis/卫报心理学空间 M|w9u$Y$J-d7?Fm
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“医学桂冠诗人”奥利弗·萨克斯。摄影:REX Shutterstock

One March in the mid 1990s I checked into a cheap hotel in Helsinki. I dropped my bag on the floor and, wondering what Finnish daytime television was like, switched on the TV. A darkened room with a dining table came into focus, and around it were six people having a conversation. To my surprise, all were speaking English, then a face I knew filled the screen – it was Oliver Sacks. Then another, Stephen Jay Gould, and another, Daniel Dennett. I had books by all three. It was snowing outside, and Helsinki seemed suddenly less inviting; I sat down on the bed and began to watch.

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o%kk1l MJ,\7~ ^0上世纪90年代中期的某个三月,我住进了赫尔辛基一家便宜的旅馆。包扔在了地板上,打开了电视,想知道芬兰白天的电视节目是什么样子。一间带餐桌的昏暗房间成了焦点,桌子周围有六个人在谈话。令我惊讶的是,电视节目中的人都在用英语对话,当时,我看到的一张面孔占据了整个屏幕——那是奥利弗·萨克斯。接下来是另一个,斯蒂芬·杰·古尔德,又是一个,丹尼尔·丹尼特。他们三个人的书我都有。外面正在下雪,赫尔辛基似乎突然不那么诱人了,我开始坐在床上看电视。

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A Dutch TV company had assembled these men, together with Freeman Dyson, Stephen Toulmin and Rupert Sheldrake, for the round-table finale of a documentary series on science and the meaning of life. The series, A Glorious Accident, didn’t seem to have invited any women to take part but even so I watched it to the end – three hours later. The participants’ areas of expertise were diverse: biology, physics, palaeontology, neuroscience, philosophy. As the only practising clinician, Sacks made perceptive and valuable contributions – and was clearly having fun. I was just starting out in medicine, and it was a relief to see how a lifetime in clinical practice offered insights still relevant across the sciences.心理学空间G q[zT*IR

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一个荷兰的电视台召集了这些人,加上弗里曼·戴森、斯蒂芬·图尔敏和鲁珀特·谢尔德雷克,他们为科学与生命意义系列纪录片的大结局进行着一场圆桌会议。这是一个辉煌的节目,似乎没有邀请任何妇女参加讨论,即使如此,我还是看了三小时,直到节目结束。参与者的专业领域是多样的:生物学家、物理学家、生物学家、神经科学家、哲学家。萨克斯作为唯一的临床执业医生,做出了敏锐而有价值的贡献。而且显得非常有趣。看到在临床实践中如此地为生命提供了贯穿整个科学领域的见解,这对于刚开始从事医学研究的我来说,是一种解脱。

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Sacks died two years ago in August. A melanoma of the eye, diagnosed nine years earlier, had recurred and metastasised to his liver. The New York Times had referred to Sacks as the “poet laureate of medicine”, and carried an obituary that said that neurological conditions were for him occasions “for eloquent meditations on consciousness and the human condition”. In his last year he put the finishing touches to a memoir (On the Move), and completed some final magazine essays collected soon after his death (Gratitude). In one of his last newspaper pieces he wrote: “I have several other books nearly finished.” We might expect further posthumous essay collections to be on the way.心理学空间;e.Bl;Dq

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萨克斯在两年前的八月去世了。一个眼部的黑色素瘤,九年前确诊,复发并转移到了肝脏。《纽约时报》曾把萨克斯称为“医学桂冠诗人”,并发表了一篇讣告说,他当时的神经状况是“意识和人类状况传神的冥想”。在他生命中的最后一年,他为自己的回忆录(On the Move: A Life)润色,并完成了死后不久出版的一些最后的杂志文集(Gratitude)。他在报纸上的最后的一篇文章中写道:“还有几本书,我几乎就要完成了。”我们可能会期待即将出版更多的文集。

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Millions of Sacks’s books have been printed around the world, and he once spoke of receiving 200 letters a week from admirers. For those thousands of correspondents, The River of Consciousness will feel like a reprieve – we get to spend time again with Sacks the botanist, the historian of science, the marine biologist and, of course, the neurologist. There are 10 essays here, the majority published previously in the New York Review of Books (the collection is dedicated to its late editor Robert Silvers). Their subject matter reflects the agility of Sacks’s enthusiasms, moving from forgetting and neglect in science to Freud’s early work on the neuroanatomy of fish; from the mental lives of plants and invertebrates to the malleability of our perception of speed.心理学空间|;wOPP*k L6j ]

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萨克斯数以百万计的书籍在世界各地印刷,他曾经说过,每周收到200封仰慕者的信。对于那些成千上万的记者而言,看到《意识的河流》,就像是萨克斯仍未过世——我们又要和作为植物学家、科学史学家、海洋生物学家以及神经科学家的萨克斯一起共度时光了。这本书有10篇文章,大多数是发表在纽约的书评(后期由Robert Silvers编纂)。这些主题反映了萨克斯敏锐的热情,从遗忘与忽视的科学到佛洛伊德早期对鱼的神经解剖工作;从植物和无脊椎动物的精神生活到对我们感知速度的延展性。

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The essay on speed has some characteristic flourishes: of Parkinson’s disease, Sacks writes that “being in a slowed state is like being stuck in a vat of peanut butter, while being in an accelerated state is like being on ice”. He is as good on near-death experiences: “There is an intense sense of immediacy and reality, and a dramatic acceleration of thought and perception and reaction.” Sacks has a Jain-like reverence for insects, and delights in comparative neuroanatomical facts: an octopus may have six times more neurons than a mouse; many plants possess nervous systems that move at a thousandth the speed of our own.

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关于速度的文章有一些蓬勃发展的特征,这是关于帕金森病的,萨克斯写道:“处于一个缓慢的状态帕金森病就像被卡在一堆花生酱中,而处于加速状态的帕金森病就像是在冰上”。在这本书中,他也提到了濒死体验方面的经验:“濒死体验有一个强烈的即时感和现实感,思维、知觉和反应速度戏剧性的加快。”萨克斯对昆虫的尊敬如同耆那教一样虔诚,而且欣喜于比较神经解剖学的事实:章鱼神经元可能是老鼠的六倍;许多植物神经系统的速度是我们的一千倍。心理学空间Y)z8R7v&gRk

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在纽约格林威治村的萨克斯,1961 Photograph: courtesy Oliver Sacks

Plagiarism troubled Sacks, and an essay on memory dovetails with one on creativity, examining how someone can copy another’s work through unconscious repatternings of memory. “Memory arises not only from experience,” he concludes, “but from the intercourse of many minds.” He quotes the letters between Mark Twain and Helen Keller on plagiarism, and his own correspondence with Harold Pinter (whose play A Kind of Alaska was inspired by Sacks’s Awakenings). Most of his books are mentioned in passing, and the chosen essays stand as a kind of testament or gazetteer to their range. Reading them, I was reminded of something Annie Dillard said about the essay form: “The essay is, and has been, all over the map. There’s nothing you cannot do with it; no subject matter is forbidden, no structure is proscribed.”

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'NBQ#S @ Qu_0抄袭的问题困扰着萨克斯,在一篇与创造力文章相结合关于记忆的文章检查了一个人是如何通过无意识的记忆重新复制了他人的作品。“记忆不仅仅来自于经验,”他总结说,“而是来自于许多思想的交流。”他引了马克·吐温和海伦·凯勒之间关于剽窃的信,以及他自己和哈罗德·品特的通信。在他大部分的书中顺便提到的,以及所选择的文章有几分圣约书或地名词典的意思。我在阅读时想起了安妮·狄勒德关于这篇文章形式的一句话:“这篇文章,早已保罗万象。你不能用它做什么;任何题材都不被禁止,任何结构都不被禁止。”心理学空间+_`(o8p$BBJ_:D q

Some of the slighter pieces here suffer from being placed between more substantial work, and in one, only one, Sacks’s argument loses coherence. But even then I was conscious of the great premium he placed on flights of ideas: “If the stream of thought is too fast, it may lose itself, break into a torrent of superficial distractions and tangents, dissolve into a brilliant incoherence, a phantasmagoric, almost dreamlike delirium.”

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在更实质性的工作中的唯一一个困扰啊是,萨克斯论点失去连贯性。但是在那个当口我意识到提出的各种想法额外巨大的红利:“如果思想流动得太快,它可能会失去自己,陷入大量表面的心烦意乱和话题突然转向的洪流,并溶化在一片灿烂的不连贯之中,成为变幻不定,几乎梦幻般的谵妄。”

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Sacks was deliriously in love with details – to the irritation of his editors – and he crammed his books with them. When the text couldn’t take any more, he spilled them over to the bottom of the page. It’s in the footnotes that his treasures are often to be found: in a two-page footnote to his essay “Scotoma: Forgetting and Neglect in Science”, Sacks outlines how urgent is the need for reconciliation between psychiatry and neurology, divided now for nearly a century. A “scotoma” is a blind spot in the vision, an area of darkness conjured by irregularities in brain or retinal function:心理学空间:[PV Ub8j"aE

/FZ{6}&A6yp0b,w;S0萨克斯极度狂热的偏爱于细节——这激怒了他的编辑们——他用细节填满了他的书籍。当教科书无法忍受这些细节的时候,他把涌出的细节放在了脚注之中。我们常常可以在脚注中发现他的宝藏:在《盲点:科学的遗忘和忽视》两页的脚注中,萨克斯勾勒了精神病学和神经病学之间急需达成和解的紧迫性。这两个学科已经分裂了一个多世纪了。盲点是视觉的盲点,大脑或视网膜功能不正常而产生的黑暗区域。心理学空间8x:]Hl3FfG

If one looks at the charts of patients institutionalized in asylums and state hospitals in the 1920s and 1930s, one finds extremely detailed clinical and phenomenological observations, often embedded in narratives of an almost novelistic richness and density ... this richness and detail and phenomenological openness have disappeared, and one finds instead meagre notes that give no real picture of the patient or his world.心理学空间2I&gR,u D7i2b7P

,i7`IEg w0如果一个人看了上世纪二三十年代精神病院和公立医院制度化的图表,人们会发现,非常详细的临床和现象学观察往往嵌入了一个几乎和小说叙事一样丰富和密集的叙述之中…这种丰富的、详细的和现象学的开放性已经消失了,人们会发现,用以替代这些的贫瘠的笔记本并没有为病人留下其真实的印象。心理学空间7T1W9C;aT

Through the course of the 20th century, the US Diagnostic and Statistical Manual of Mental Disorders (a book conceived to facilitate health insurance billing) has, Sacks insists, impoverished clinical language. “Present-day psychiatric charts in hospitals are almost completely devoid of the depth and density of information one finds in the older charts, and will be of little use in helping us to bring about the synthesis of neuroscience with psychiatric knowledge that we so need.” Earlier in the book he singled out one of the defining moments of that schism, when in 1893 Freud gave up looking for elements of brain pathology that might be relevant to mental health: “The lesion in hysterical paralyses must be completely independent of the nervous system,” Freud wrote, “since in its paralyses and other manifestations hysteria behaves as though anatomy did not exist or as though it had no knowledge of it.”心理学空间ao3| d`Keo-L,r

{x(g\1Mo3p cV0萨克斯坚持认为,在二十世纪的进程中,《美国精神疾病诊断与统计手册》(一本旨在促进健康保险账单的书)让临床语言变得贫瘠和恶化。“现今医院的精神病学图谱几乎完全缺乏人们在旧图谱中了解的信息之深度和密度。几乎无法帮助我们利用我们所需要的精神病知识来实现神经科学的综合推理。”他在书中指出了一个早期分裂的决定性时刻,即,佛洛伊德在1893年放弃寻找可能与精神健康有关的脑病理学元素:“歇斯底里麻痹的病理性损伤必须完全独立于神经系统,”佛洛伊德写道,“因为其麻痹以及与癔症有关的其他表现,好像在解剖中并不存在,或者好像毫不了解。”心理学空间4z pUvz5a

We’re still suffering the consequences of that schism: neurological dualism is alive and well. It’s estimated that around a third of patients referred to neurological clinics have no “lesion” that tests or scans can identify. But their problems are not “all in their head” – that catch-all, meaningless phrase that to many implies malingering or hypochondria. Functional illness is neither, and modern psychiatry no less than neurology is tragically ill‑equipped to deal with it. In that Helsinki hotel room I saw Sacks break out of the silos of his training, and offer a more humane vision of what communion between the specialties might bring. Two years after his death, he’s still reminding us that a unified vision is long overdue.心理学空间?b jL bp k2y

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精神病学和神经病学分裂的后果依旧困扰着我们:神经病学的二元论依旧活跃而且相安无事。据估计,大约三分之一的神经内科患者检测不出或扫描不出“器质性损伤”。但是他们的问题不是“都在他们头脑之中”的那些意味着装病或忧郁症的包罗万象,毫无意义的短语。功能性疾病既不是现代精神病学,也不只是神经病学需要处理的不幸疾病。在赫尔辛基的旅馆的房间里,我看到萨克斯从他的训练中突围而出,并提供了一种更人性化的视野,看看专业之间的交流会带来什么。他去世两年后,他仍然提醒我们,早就应该有一个统一的远见了。心理学空间 cQ9B4|%o+Ou5`

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Gavin Francis/卫报 作者:Gavin Francis/卫报 / 689次阅读
时间:2017年10月19日
来源: 陈明 译
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