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Authors: Oliver Sacks

BOOK: Hallucinations
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And when the effects were most intense, there came a rich synesthesia—a mingling of all the senses, and of sensation and concepts. Breslaw noted, “Interchanges between the senses are frequent and astonishing: One knows the smell of a low B
flat, the sound of green, the taste of the categorical imperative (which is something like veal).”

No two people ever have the same responses to such drugs; indeed, no two drug experiences are ever the same for the same person. Eric S. wrote to me to describe some of his experiences with LSD during the 1970s:

I was in my late twenties when a friend and I took some LSD. I had tripped many times before but this acid was different.… We noticed that we were talking to each other mentally through thoughts only, no verbal talk, tele-communicating. I thought in my head, “I want a beer,” and he heard me and got me a beer; he thought, “Turn the music up” and I turned the music up.… It went on like this for some time.

Then I went to urinate, and in my urine stream was a video or movie of the past played back in reverse. Everything that had just happened in the room was coming out of me like watching a movie in my urine stream, playing in reverse. This totally blew my mind.

Then my eyes became a microscope, and I looked at my wrist and was able to see each individual cell breathing or respirating, like little factories with little puffs of gas shooting out of each cell, some blowing perfect smoke rings. My eyes were able to see inside each skin cell, and I saw that I was choking myself from the inside by smoking five packs of cigarettes a day and the debris was clogging my cells. At that second I quit smoking.

Then I left my body and hovered in the room above the whole scene, then found myself traveling through a tunnel of beautiful light into space and was filled with a feeling of total love and acceptance. The light was the most beautiful,
warm and inviting light I ever felt. I heard a voice ask me if I wanted to go back to Earth and finish my life or … to go in to the beautiful love and light in the sky. In the love and light was every person that ever lived. Then my whole life flashed in my mind from birth to the present, with every detail that ever happened, every feeling and thought, visual and emotional was there in an instant. The voice told me that humans are “Love and Light.” …

That day will live with me forever; I feel I was shown a side of life that most people can’t even imagine. I feel a special connection to every day, that even the simple and mundane have such power and meaning.

T
he effects of cannabis, mescaline, LSD, and other hallucinogenic drugs have an immense range and variety. Yet certain categories of perceptual distortion and hallucinatory experience may, to some extent, be regarded as typical of the brain’s responses to such drugs.

The experience of color is often heightened, sometimes to an unearthly level, as Weir Mitchell, Huxley, and Breslaw all observed. There may be sudden changes in orientation and striking alterations of apparent size. There may be micropsia or Lilliputian vision (little beings—elves, dwarfs, fairies, imps—are curiously common in these hallucinations), or there may be gigantism (macropsia).

There may be exaggerations or diminutions of depth and perspective or exaggerations of stereo vision—or even stereo hallucinations, seeing three-dimensional depth and solidity in a flat picture. Huxley described this:

I was handed a large colored reproduction of the well-known self-portrait by Cézanne—the head and shoulders of a man in a large straw hat, red-cheeked, red-lipped, with rich black whiskers and a dark unfriendly eye. It is a magnificent painting; but it was not as a painting that I now saw it. For the head promptly took on a third dimension and came to life as a small goblin-like man looking out through a window in the page before me.

The perceptual transformations and hallucinations induced by mescaline, LSD, and other hallucinogens are predominantly, but not exclusively, visual. There may be enhancements or distortions or hallucinations of taste and smell, touch and hearing, or there may be fusions of the senses—a sort of temporary synesthesia—“the smell of a low B flat, the sound of green,” as Breslaw put it. Such coalescences or associations (and their presumed neural basis) are creations of the moment. In this way they are quite different from true synesthesia, a congenital (and often familial) condition where there are fixed sensory equivalences that last a lifetime. With hallucinogens, time may appear to be distended or compressed. One may cease to perceive motion as continuous and see instead a series of static “snapshots,” as with a film run too slowly. Such stroboscopic or cinematic vision is a not uncommon effect of mescaline. Sudden accelerations, slowings, or freezings of movement are also common with more elementary hallucinatory patterns.
7

I
had done a great deal of reading, but had no experiences of my own with such drugs until 1953, when my childhood friend Eric Korn came up to Oxford. We read excitedly about Albert Hofmann’s discovery of LSD, and we ordered 50 micrograms of it from the manufacturer in Switzerland (it was still legal in the mid-1950s). Solemnly, even sacramentally, we divided it and took 25 micrograms each—not knowing what splendors or horrors awaited us—but, sadly, it had absolutely no effect on either of us. (We should have ordered 500 micrograms, not 50.)

By the time I qualified as a doctor, at the end of 1958, I knew I wanted to be a neurologist, to study how the brain embodies consciousness and self and to understand its amazing powers of perception, imagery, memory, and hallucination. A new orientation was entering neurology and psychiatry at that time; it was the opening of a neurochemical age, with a glimpse of the range of chemical agents, neurotransmitters, which allow nerve cells and different parts of the nervous system to communicate with one another. In the 1950s and 1960s, discoveries were coming from all directions, though it was far from clear how they fit together. It had been found, for instance, that the parkinsonian brain was low in dopamine, and that giving a dopamine precursor, L-dopa, could alleviate the symptoms of Parkinson’s disease, while tranquilizers, introduced in the early 1950s, could depress dopamine and cause a sort of chemical parkinsonism. For about a century, the staple medication for parkinsonism had been anticholinergic drugs. How did the dopamine and acetylcholine systems interact? Why did opiates—or cannabis—have such strong effects? Did the brain have special opiate receptors and make opioids of its own? Was there a similar mechanism for cannabis receptors and
cannabinoids? Why was LSD so enormously potent? Were all its effects explicable in terms of altering the serotonin in the brain? What transmitter systems governed wake-sleep cycles, and what might be the neurochemical background of dreams or hallucinations?

Starting a neurology residency in 1962, I found the atmosphere heady with such questions. Neurochemistry was plainly “in,” and so—dangerously, seductively, especially in California, where I was studying—were the drugs themselves.

While Klüver had little idea of what the neural basis of his hallucinatory constants might be, rereading his book in the early 1960s was especially exciting to me in light of the groundbreaking experiments on visual perception that David Hubel and Torsten Wiesel were performing at the time, recording from neurons in the visual cortex in animals. They described neurons specialized for the detection of lines, orientations, edges, corners, etc., and these, it seemed to me, if stimulated by a drug or a migraine or a fever, might well produce just such geometrical hallucinations as Klüver had described.

But mescal hallucinations did not stop with geometrical designs. What was happening in the brain when one hallucinated more complex things: objects, places, figures, faces—let alone the heaven and hell that Huxley had described? Did
they
have their own basis in the brain?
8

Thoughts like this tipped the balance for me, along with the feeling that I would never really know what hallucinogenic drugs were like unless I tried them.

I
started with cannabis. A friend in Topanga Canyon, where I lived at the time, offered me a joint; I took two puffs and was transfixed by what happened then. I gazed at my hand, and it seemed to fill my visual field, getting larger and larger while at the same time moving away from me. Finally, it seemed to me, I could see a hand stretched across the universe, light-years or parsecs in length. It still looked like a living, human hand, yet this cosmic hand somehow also seemed like the hand of God. My first pot experience was marked by a mix of the neurological and the divine.

On the West Coast in the early 1960s, LSD and morning glory seeds were readily available, so I sampled those, too. “But if you want a really far-out experience,” my friends on Muscle Beach told me, “try Artane.” I found this surprising, for I knew that Artane, a synthetic drug allied to belladonna, was used in modest doses (two or three tablets a day) for the treatment of Parkinson’s disease, and that such drugs, in large quantities, could cause a delirium (such deliria have long been observed with accidental ingestion of plants like deadly nightshade, thorn apple, and black henbane). But would a delirium be fun? Or informative? Would one be in a position to observe the aberrant functioning of one’s brain—to appreciate its wonder?
“Go on,” urged my friends. “Just take twenty of them—you’ll still be in partial control.”

So one Sunday morning, I counted out twenty pills, washed them down with a mouthful of water, and sat down to await the effect. Would the world be transformed, newborn, as Huxley had described it in
The Doors of Perception
, and as I myself had experienced with mescaline and LSD? Would there be waves of delicious, voluptuous feeling? Would there be anxiety, disorganization, paranoia? I was prepared for all of these, but none of them occurred. I had a dry mouth, large pupils, and found it difficult to read, but that was all. There were no psychic effects whatever—most disappointing. I did not know exactly what I had expected, but I had expected
something
.

I was in the kitchen, putting on a kettle for tea, when I heard a knocking at my front door. It was my friends Jim and Kathy; they would often drop round on a Sunday morning. “Come in, door’s open,” I called out, and as they settled themselves in the living room, I asked, “How do you like your eggs?” Jim liked them sunny side up, he said. Kathy preferred them over easy. We chatted away while I sizzled their ham and eggs—there were low swinging doors between the kitchen and the living room, so we could hear each other easily. Then, five minutes later, I shouted, “Everything’s ready,” put their ham and eggs on a tray, walked into the living room—and found it completely empty. No Jim, no Kathy, no sign that they had ever been there. I was so staggered I almost dropped the tray.

It had not occurred to me for an instant that Jim and Kathy’s voices, their “presences,” were unreal, hallucinatory. We had had a friendly, ordinary conversation, just as we usually had. Their voices were the same as always; there had been no hint, until I opened the swinging doors and found the living room
empty, that the whole conversation, at least their side of it, had been completely invented by my brain.

I was not only shocked, but rather frightened, too. With LSD and other drugs, I knew what was happening. The world would look different, feel different; there would be every characteristic of a special, extreme mode of experience. But my “conversation” with Jim and Kathy had no special quality; it was entirely commonplace, with nothing to mark it as a hallucination. I thought about schizophrenics conversing with their “voices,” but typically the voices of schizophrenia are mocking or accusing, not talking about ham and eggs and the weather.

“Careful, Oliver,” I said to myself. “Take yourself in hand. Don’t let this happen again.” Sunk in thought, I slowly ate my ham and eggs (Jim and Kathy’s, too) and then decided to go down to the beach, where I would see the real Jim and Kathy and all my friends, and enjoy a swim and an idle afternoon.

I was pondering all this when I became conscious of a whirring noise above me. It puzzled me for a moment, and then I realized it was a helicopter preparing to descend, and that it contained my parents, who, wanting to make a surprise visit, had flown in from London and, arriving in Los Angeles, had chartered a helicopter to bring them to Topanga Canyon. I rushed into the bathroom, had a quick shower, and put on a clean shirt and pants—the most I could do in the three or four minutes before they arrived. The throb of the engine was almost deafeningly loud, so I knew that the helicopter must have landed on the flat rock beside my house. I rushed out, excitedly, to greet my parents—but the rock was empty, there was no helicopter in sight, and the huge pulsing noise of its engine had abruptly cut off. The silence and emptiness, the
disappointment, reduced me to tears. I had been so joyfully excited, and now there was nothing at all.

I went back into the house and had put on the kettle for another cup of tea when my attention was caught by a spider on the kitchen wall. As I drew nearer to look at it, the spider called out, “Hello!” It did not seem at all strange to me that a spider should say hello (any more than it seemed strange to Alice when the White Rabbit spoke). I said, “Hello, yourself,” and with this we started a conversation, mostly on rather technical matters of analytic philosophy. Perhaps this direction was suggested by the spider’s opening comment: did I think that Bertrand Russell had exploded Frege’s paradox? Or perhaps it was its voice—pointed, incisive, and just like Russell’s voice (which I had heard on the radio, but also—hilariously—as it had been parodied in
Beyond the Fringe
).
9

D
uring the week, I would avoid drugs, working as a resident at UCLA’s neurology department. I was amazed and moved, as I had been as a medical student in London, by the range of patients’ neurological experiences, and I found that I could not comprehend these sufficiently, or come to terms with them emotionally, unless I attempted to describe or transcribe them. It was then that I wrote my first published papers and my first book (it was never published, because I lost the manuscript).

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