Kirk Wu

Nitzan Rotenberg

University Writing

21 September 2017

Formal Draft

In his essay “A General Feeling of Disorder,” Oliver Sacks transforms from a doctor who

comprehends scientific minutiae and has had patients with migraines to a patient who has

undergone palliative treatment for terminal liver cancer. Sacks establishes the expectation that

these illnesses will only be detrimental, with descriptions of migraines as painful, cancer

treatment as excruciatingly tiring, and disorders generally as “intrusive [and] unpleasant” (1).

But he soon subverts that very expectation, as he details the creative energy some, including

himself, have experienced in the recovery from similar episodes of illness. By suggesting that

illnesses transcend beyond our physical symptoms, he bridges the gap between our subjective

experiences and our physical states.

As a physician, Sacks recounts his experiences with patients and cites the self-

descriptions of others with migraines—individuals who indefinably but undeniably feel

“something amiss,” or what he characterizes as “a general feeling of disorder” (2). Sacks initially

cites the typical presentation of the common migraine: a “slight” but “bearable” pain which

usually subsides towards evening (2). The preoccupation with the feelings associated with

migraines conditions the readers think about illnesses in those same terms. But these descriptions

become increasingly morbid, as migraines can reduce patients to “lying in a leaden haze, feeling

half-dead,” or, in worst of cases, make them feel as if “death would be preferable” (2). His

emphasis on the most horrific possible symptoms of migraines—associating migraines with

death—instills such a negative psychological impact in the readers that there is no room in their

minds for any positive possible outcome from the resolution of a migraine.

This trend continues as Sacks spirals into a much more personal discussion with his own

bout with cancer. In the aftermath of his palliative treatment, he experiences a similar general

feeling of disorder except the displeasure is “raised to an almost infinite degree” (3). He would

experience a “tiredness beyond anything [he has] had ever felt before,” attacks of delirium,

swelling of the feet so severe that “they were almost unrecognizable as feet,” and unstable

temperature regulation so that he would be “hot one minute [and] cold the next” (3). The feeling

of disorder is so extreme that he thinks he “would sooner be dead” (3). Certainly, we hope for

Sacks’ peaceful recovery, but the word choice that Sacks employs leaves little room for us to

expect that. Furthermore, the vivid imagery of disorder and the repetition of a death-like feeling

parallels the descriptions of migraines, elucidating that although migraines and cancer differ

drastically in terms of lethality, all diseases share universal qualities of general feelings of

disorder and universalizes the message that Sacks’ attempts to convey.

But if Sacks’ goal is to complicate these general feelings of disorder, he has yet to do so.

Sacks introduces, defines, and describes these general feelings of disorder, setting up the

expectation that the text will be constrained to those same descriptions. After all, when people

hear the term disorder, they typically imagine the negative symptoms associated with an illness.

However, he abruptly shifts in both tone and content immediately after describing the symptoms

of migraines and cancer treatment, and they are no longer only painful, nearly death-inducing

diseases. Instead, he describes the instances of creative energy individuals have experienced

from the recuperation of such illness. By problematizing the descriptions of general feelings of

disorder as not only negatively impacting our physical states but also possibly contributing to our
identities, he exemplifies that illnesses not only describe how one feels but also can tell us who

we are.

For some, these illnesses have somehow situated themselves into a central part of their

hosts’ identity. Sacks cites someone who often feels “dangerously well” and “full of energy”

after a migraine (2). Some patients can channel this energy into whatever pursuits they wish.

Sacks provides the example of one of his patients, a mathematician, who, in the resolution of a

migraine, experiences “a burst of original mathematical thinking” and “creativity” (2). This surge

in energy has become so important to him that he is willing to disregard the physical discomfort

and decides to keep both the migraine and its resolution. Ironically, his physical sickness has

become his mental cure. The two are no longer separate entities; rather, they affect and inform

one another. The juxtaposition of descriptions of a general feeling of disorder and the possible

energy experienced in its recovery illuminates how disorders can both impact how we feel and

contribute to any purpose central to our identities.

The overall pattern of the text supports the claim that sickness informs our identity. The

beginning of the text establishes a clear dichotomy between thinking and feeling: the central

nervous system “tells one who one is” (1) but the autonomic nervous system “tells one how one

is” (1). Ralph Waldo Emerson also reinforces that dichotomy when he states, “‘I have lost my

mental faculties but am perfectly well’” (1) after he developed Alzheimer’s. Similarly, migraines

provide “the essential features of being ill… without actual illness” (1) in that they influence

only feeling and not thinking. How we think is the foundation of our identity, since thinking

dictates how we perceive and experience the world around us. But these excerpts build a pattern

that feeling and thinking are seemingly disparate, with illnesses only affecting the former, to

build an expectation that general feelings of disorder are unable to influence who we are.
 However, the division between thinking and feeling becomes blurrier as individual

examples break that established pattern. For the mathematician, migraines do not only provide

the physical features of being ill; rather, he has accepted and welcomed them. When Sacks refers

to his own recovery from the pains of palliative treatment, he is unsure how much of it to

attribute to a natural “reestablishment of balance in the body,” “an autonomic rebound,” “other

physiological factors,” or simply “the sheer joy of writing” (3). By placing various physiological

factors, a type of feeling, in the same list as the joy of writing, a type of thinking that is central to

Sacks’ identity, as the causes for his recovery, he suggests that both how one thinks can be just

as potent as how one feels in influencing illness.

His personal examples of illness culminate in lessons for our species as a whole. He

concludes his essay with an excerpt from Nietzsche’s The Gay Science: “Gratitude pours forth

continually … for convalescence was unexpected…. The rejoicing … of a reawakened faith in a

tomorrow” (4). By invoking a philosopher like Nietzsche in the very last paragraph, Sacks

advocates that his personal anecdote should not be remembered as a singular example but as

having philosophical importance for humankind at large. Feeling and thinking are

interconnected, as both the unexpected convalesce creates a reawakened faith in the future and

such a trust in what lies ahead paves the mental conditions for a physical recovery.

What ultimately ties Sacks to Nietzsche, however, is Nietzsche’s philosophy on suffering.

Nietzsche forwards that suffering is inevitable, and only by overcoming such suffering can we

satisfy our innate desire to expand our own power (Nietzsche). Similarly, illness is inevitable, as

we are bound to eventually get sick. In that situation, should we embrace illness in our pursuit

for our will to power? No, Sacks is not advocating for giving up modern medicine and letting

illnesses run rampant. Rather, he takes a more nuanced approach, suggesting we should
understand how general feelings of disorders situate themselves in us and realize their impact

upon who can become.

Works Cited

Sacks, Oliver. “A General Feeling of Disorder.” The New York Review of Books,

www.nybooks.com/articles/2015/04/23/general-feeling-disorder/. Accessed 1 Oct. 2017.

Nietzsche, Friedrich Wilhelm, Walter Kaufmann, and R. J. Hollingdale. The Will to Power. New

York: Vintage Books, 1968.