`This Internal Militia'

In Awakenings, after giving us the case histories of twenty patients he roused from decades of sleeping sickness with L-DOPA – the most elegantly literate case histories you’ll ever read – Oliver Sacks reflects on them in a section titled “Perspectives.” His reflections, though rooted in recent research in medicine and pharmacology, have a seventeenth-century flavor about them, recalling the meditations of that other physician-writer, Sir Thomas Browne. Here is Sacks:

“Our sense that there is something the matter, that we are ill or in error, that we have departed from health, that we are possessed by disorder and no longer ourselves – this is basic and intuitive in us; and so too is the sense of coming to or awakening, of resipiscence or recovery, being restored to ourselves and the world: the sense of health, of being well, fully alive, in-the-world.”

The style is rich without exhibitionism. There’s a sense of striving after precision, and the striving is part of the story, for Sacks is exploring an ineffable region where disease and health, medicine and psychology, overlap and mingle. Without explicitly saying so, he’s searching for an elastic definition of what it means to be human. Sacks describes such language as “metaphysical terms – the terms we use for infinite things.”

My spell-check software fails to recognize one of Sacks’ terms – resipiscence. In his Dictionary, Johnson defines this Johnsonian word as “wisdom after the fact; repentance.” The Latin root is helpful: resipiscere, “to become reasonable again; recover, come to the senses.” The word first shows up in Awakenings some one hundred and sixty pages earlier in the first case history, devoted to Frances D.:

“…the attack would finally end quite suddenly, with restoration of normal movement, speech, and thought (this sudden restoration of normal consciousness Miss D. – a crossword addict – would call `resipiscence’).”

It’s typical of Sacks to give this lovely, faintly antiquated word to one of his patients. Throughout Awakenings he's equally generous with borrowings from both medical and literary writers, in particular Donne and Browne. On the second page of the “Perspectives” section he quotes from the latter’s Christian Morals, Part 1, Section XXIV:

“To well manage our Affections, and wild Horses of Plato, are the highest Circenses; and the noblest Digladiation is in the Theater of our selves: for therein our inward Antagonists, not only like common Gladiators, with ordinary Weapons and down right Blows make at us, but also like Retiary and Laqueary Combatants, with Nets, Frauds, and Entanglements fall upon us. Weapons for such combats are not to be forged at Lipara: Vulcan's Art doth nothing in this internal Militia…”

I love Browne’s verbal riffs. “Circenses” we know from panem et circenses, “bread and circuses,” first used in Juvenal’s “Satire X” and meaning the acquisition and retention of political power through empty populist gestures – giving the people what they want. “Circuses” would include the Roman gladitorial games, reiterated by Browne with “Digladiation.” “Retiary” means resembling a net and “Laqueary” is an adjective that means using a noose, as a gladiator might. “Lipara” is the Latin name for the Sicilian island of Lipari, part of the volcanic archipelago between Vesuvius and Etna. Vulcan was the god of volcanic fire.

Sacks endorses Browne’s schema of disease and health as inner conflict, a sort of elevated gladiatorial contest. After the Browne passage he writes:

“These are the terms in which we experience health and disease, and which we naturally use in speaking of them. They neither require nor admit definition; they are understood at once, but defy explanation; they are at once exact, intuitive, obvious, mysterious, irreducible, and indefinable. They are metaphysical terms – the terms we use for infinite things. They are common to colloquial, poetic, and philosophical discourse. And they are indispensible terms in medical discourse, which unites all of these. `How are you?’, `How are things?’, are metaphysical questions, infinitely simple and infinitely complex.”