[RADIOLAB INTRO]

JAD ABUMRAD: Hey, I'm Jad Abumrad.

ROBERT KRULWICH: I'm Robert Krulwich.

JAD: This is Radiolab. And a couple days ago—as in, like, seven—we were on stage at the Brooklyn Academy of Music, the big opera house there.

ROBERT: It's a really beautiful theater, and it was full of more than 2,000 people. We were part of something called RadioLoveFest.

JAD: Welcome to RadioLoveFest!

JAD: RadioLoveFest is a big public radio podcasting, radio love-y thing that WNYC, the station here puts on. Basically, it's a parade of all these amazing public radio shows and podcasts. We opened the festival, and since it was called RadioLoveFest, we figured we would use the opportunity to basically talk about the community of people around Radiolab that we love, the producers, the musicians. It features amazing acts like Sō Percussion, who you're hearing. A lot of stuff happened, and we told a lot of stories. Today we're just—on this podcast, we're gonna play two stories for you, these are both stories about love and about heart.

ROBERT: The last one which you'll hear is an exclusive interview with Oliver Sacks, basically giving a kind of valedictory interview. It's pretty wonderful. But first, we decided to do literally a look at a heart.

JAD: This comes from our producer, Molly Webster. It was scored live by Sō Percussion, which is Eric Cha-Beach, Josh Quillen, Jason Treuting and Adam Sliwinski.

ROBERT: Oh, and some people in the audience, in the theater audience, had a pretty strong reaction to what you are about to hear, and we are not so sure that that might not also be the case if you're just listening. So if you are driving or you're operating machinery, maybe this isn't the best piece to listen to because it can get a little intense.

JAD: Which we'll talk about a little bit afterwards. In the meantime, here's producer Molly Webster.

MOLLY WEBSTER: So this is a story about a friend, Summer Ash. We used to work together, and I think it's fair to say that Summer has a complicated relationship with her heart.

SUMMER ASH: You know, my heart was not beating for three hours, which is a really crazy thought.

MOLLY: Yeah.

SUMMER ASH: I was technically heart dead. I don't know.

MOLLY: So a couple of things to know about Summer: she's, like, wicked smart. She's an astrophysicist. She uses a lot of big words.

SUMMER ASH: Propulsion, center of gravity and moment of inertia. X and Y. Z axis. Do you remember that original radial keratotomy?

MOLLY: Like, no. I don't even know what that word is.

[laughter]

MOLLY: The other thing to know is she's an engineer, right? So she loves to take things apart and sort of like, poke around, rewire, ratchet. Ooh, you got a ratchet! And so the thing to know is when she found out she had to get heart surgery, she made sure there was someone in the operating room with a camera taking pictures.

SUMMER ASH: Of my open chest cavity and the valve, and when things were cut and when things were being sewn in.

MOLLY: What?

SUMMER ASH: Yeah. I totally approached this completely as a scientist. I want to know what's happening. I want to know why. I want to know what you're doing. I want to know what's going on around me.

MOLLY: And in any case, to sort of back up and explain, Summer was just following up on, like, a heart diagnosis that had happened about 15 years earlier. And so she had been diagnosed with a murmur, which is basically just like a funny sound in your heart, and that's like a whoosh in between the thump thumps, like thump, whoosh, thump. And in Summer's case, she had been told it's no big deal, and so this was just a follow-up appointment to make sure nothing had changed. And so she goes to the doctor, they run a few tests, and then they send her on her way. And a few weeks later, she gets an email saying ...

SUMMER ASH: "Don't panic, but I think you should see a heart surgeon."

MOLLY: It turns out the situation with her heart had changed. Her aorta, which is like the largest artery coming out of her heart, it was larger than it should have been. So it's supposed to be about two centimeters in diameter, and in Summer's case, it was five.

SUMMER ASH: Yeah.

MOLLY: What does that mean for your body?

SUMMER ASH: So that's the thing: it's asymptomatic. It's not actively harming you, but it's a threat to your life, because if it ruptures, it's your main blood vessel, and if it goes, you bleed out internally so fast that no ER can help you.

MOLLY: Her doctor says, "Go find a heart surgeon, and in the meantime, no heavy lifting or contact sports." And Summer's like, "What?"

SUMMER ASH: I live in New York. Like, living in New York is a contact sport.

MOLLY: Yeah, I was gonna say, people crash into you all the time.

SUMMER ASH: Yeah.

MOLLY: Six months later, Summer finds herself on the operating table.

SUMMER ASH: They actually, I think—I'm not sure the exact order of operations, but they ...

MOLLY: They cut open her sternum from the bottom all the way up to the top, and then they just, like, pull. They pull back a rib cage so they can get at her heart.

SUMMER ASH: They put some sort of fluid on it that stops it from beating.

MOLLY: And they actually sort of just inject that fluid into the heart, and that short circuits it.

SUMMER ASH: So your heart actually stops. And then they hook you up to a bypass, a heart-lung bypass machine.

MOLLY: And one of the things that does is it drains the heart of all its blood, and so it's like, flat like a pancake. And you can see pictures of all of this on her blog. You can even see pictures—true. You can even see pictures of the surgeon cutting four inches out of her aorta and replacing it with a synthetic tube. And the entire time, Summer's heart is just limp and quiet. Eight hours later, she wakes up. What do you remember about your first conversation with your doctors?

SUMMER ASH: Oh, I don't remember my first conversation much, but I do vividly remember my first thought, pardon my French, was "[bleep] This hurts!"

MOLLY: Just mind-altering pain.

SUMMER ASH: Oh my God, eight hours ago, I felt so much better than this. Can we just go back to that now? Like, no, I don't want this. You know, everything pulls on your torso, and so when your sternum's been cut open and then reconnected, everything that pulls on that hurts. You can't move anything or lift anything.

MOLLY: It hurt to talk. It even hurt to breathe.

SUMMER ASH: But literally from day one, they make you stand up and start walking.

MOLLY: Really?

SUMMER ASH: I was like—she was like, "We're gonna get you to sit in the chair." I was like, "No. No, we're not. What are you talking—what are you smoking?"

MOLLY: And that's just to ...

SUMMER ASH: That's just to—basically, you just gotta get the heart going again, you know, just get it healing.

MOLLY: But here's the thing: when it came back, it came back with a vengeance. So to be fair, her recovery went really well. About two months in, she's in cardiac rehab, the pain is fading, she's thinking about sending her mother home. Her mom had been staying with her for a while. And then one day, she's in cardiac rehab on the elliptical machine.

SUMMER ASH: And so I remember stopping, and I had this white t-shirt that would literally, like, just be fluttering with my heartbeat. Like, it was blowing in the high winds or something. And I was like, "Well, that's interesting."

JAD: You mean that you could see it?

SUMMER ASH: Oh, yeah. Yeah. Even the physical therapist there could see it.

JAD: Wait, wait, wait, wait. You mean, like, you would look down and you would see the thing—your heart beating through your chest wall, pushing your shirt off your chest?

SUMMER ASH: Yes. Well, because I'm a lady, there was a gap here. So, like, that sort of—there's a space for that vibration to happen, so to speak.

[laughter]

MOLLY: But then she goes home, and it was still happening, like, just sitting on her couch, not even working out, and she's like, "Whoa, my heart is strong!"

SUMMER ASH: It just felt so strong that I—part of me was like, "Am I going crazy?"

MOLLY: Like, is it as strong as it seems like it is? Because if it is ...

SUMMER ASH: Surely this is making a noise.

MOLLY: So one day, a few months after surgery, she goes to upstate New York. She's visiting some family friends, and she's hanging out with their daughter, Julia.

JULIA: She walked in, and we were standing in my room.

MOLLY: They're just chatting, and then suddenly, Julia's eyes get really wide.

JULIA: And I was standing there just, "Oh, my gosh! I just heard it!"

MOLLY: She could hear Summer's heart out loud two feet away from her in the room.

SUMMER ASH: And I was like, okay, this is happening.

MOLLY: So I guess in typical Summer fashion, she's kind of like, "Let's engineer this."

SUMMER ASH: [bleep] If a friend of mine can hear it with their ear, what could a studio pick up?

MOLLY: So she grabs a radio producer friend, they go to a studio and he sticks a mic about six inches in front of her chest. And this is what they recorded.

[heartbeat]

MOLLY: This is not a stethoscope. This is what it sounds like if you were standing in a quiet room next to Summer. God, that's strong. What does that feel like?

SUMMER ASH: It just feels as if my entire ribcage—my clavicle, my sternum, my whole chest cavity is acting like an amp, and it's sort of transmitting the vibrations of each heartbeat physically in my body.

JAD: So you feel each heartbeat?

SUMMER ASH: Yeah.

JAD: Do you feel it right now?

SUMMER ASH: Yeah.

JAD: You can just feel the thump-thump, thump-thump?

SUMMER ASH: Yep. It feels like somebody has a rubber mallet and is banging on the inside of my sternum. And it's very staccato.

MOLLY: When she goes back to the doctor, she's like, "Dude, my heart!"

SUMMER ASH: So he sort of just did some, like, listening and some feeling.

MOLLY: Uh-huh.

SUMMER ASH: You know, and his reaction, too, was like, "Yeah, that's strong."

[laughter]

MOLLY: So he runs some tests, and he's like, "Listen, your blood pressure's fine. All of your stats are fine. So I guess I did a really good job."

[laughter]

SUMMER ASH: Yay. Good for you! But—but, okay, I guess I have a strong heart. Yay, strong heart, but I don't want to feel this all the time.

MOLLY: The doctor was like, "Whoa, whoa, whoa! Don't freak out. This will go away. It's probably just that there's scar tissue on your sternum, and it's transmitting the vibration, and as that goes away, the sensation should fade."

SUMMER ASH: He said sometimes six to nine months is when maybe the scar tissue heals more, thins out.

MOLLY: So she's like, all right, nine months.

SUMMER ASH: Oh, I can get to that. That's no problem.

MOLLY: So she sort of just settled in and treated it like a scientific curiosity.

SUMMER ASH: Like a party trick. If I went to a restaurant where they had, like, tables for two, but they weren't, like, the sturdiest of tables, if we had water glasses on them, and I—I sort of leaned on the table, like, the water glass would look like Jurassic Park.

[laughter]

SUMMER ASH: Like, my heartbeat would be like the footsteps of the Tyrannosaurus rex.

MOLLY: [laughs]

SUMMER ASH: Yeah, so that was like my party trick.

MOLLY: So you had six months of elation party trick, and then ...

SUMMER ASH: Yeah.

MOLLY: And then it stopped being a party trick, it sounds like.

SUMMER ASH: Yeah.

MOLLY: What happened?

SUMMER ASH: And I'm not really sure, like, you know, incident wise. I think for me it was just time passing.

MOLLY: Because that nine-month mark ...

SUMMER ASH: Just came and went.

MOLLY: And it was still there. And when she asks her doctor ...

SUMMER ASH: He has no idea why.

MOLLY: So 12 months, still there. 15 months, it's still there. And she says it just started getting really annoying.

SUMMER ASH: It was distracting. The funny thing was, the more active I was, then the less aware of it I was.

MOLLY: But she says when she was at her office trying to be still ...

SUMMER ASH: Be still, to either be writing something, writing emails, planning lectures ...

MOLLY: That's when it would be, like ...

SUMMER ASH: Really loud. That's when it would become the most dominant thing. Like, I couldn't go to work because it just kept drawing my focus.

MOLLY: And when it did, it would just fill her with anxiety. It was sort of this, like, automatic response. And I'll try and explain it, but it's basically like when you get scared, it goes into your brain, and then the signal goes down into your body. So you step on a snake, and your brain is like, "Oh, my God, it's a snake! Run, body, run!" And then your heart pounds. In Summer's case, it was just the opposite: there was no snake, but her heart was pounding, so her brain would be like, "Whoa, why is my heart pounding? Oh, my God, is there a snake? There must be a snake! Run, body, run!" And her heart would pound.

SUMMER ASH: My brain keeps thinking something must be wrong because we're already doing this, so something must be wrong. So I guess something's wrong, so let's freak out.

MOLLY: She was caught in this feedback loop, and then she was, like, rightly so edgy and primed that any emotion on top of that, like, even if it was happiness, was just too much.

SUMMER ASH: Oh my gosh, yeah.

MOLLY: At nights ...

SUMMER ASH: It would keep me awake. I would focus on it. I would get into hearing the rhythm, feeling the rhythm, you know, sort of with the expectation of just next one, next one, next one, next one, next one, next one, next one, next one, one, next one, next one, one, next one, next one, one, next one, next one, one, next one, next one, next one, next one, next one.

MOLLY: With every beat, our hearts are just literally tapping out time. And I mean, researchers have actually thought about this, and there was this idea that was proposed, like, right before the dawn of sort of modern heart surgery, that we each get one billion beats in our lifetime, and then that's it. And most of us don't notice them going by, but in Summer's case, she can't not notice it.

SUMMER ASH: Yeah, I'm aware of it always. It's never not there. It's never not noticeable.

MOLLY: That beat. I mean, it's just like this constant awareness of the future that Summer is endlessly meditating on.

SUMMER ASH: My heart takes over, and I can't do the things that I want to do. And not knowing if that's gonna last forever or if it's gonna end suddenly or if it's just gonna peter out. The not knowing gets me.

MOLLY: So she stopped going out as much. She stopped returning phone calls except for, like, a few close group of friends.

SUMMER ASH: The worst times were just being curled up in bed and just crying. I really wanted to yell at my heart, "Shut up! Stop!"

JAD: Would you really talk to your heart?

SUMMER ASH: Well I mean, I would never have conversations, but I would be like, "Shut the [bleep] up!"

MOLLY: But it wouldn't. And as time went on, like, the constant pounding, it just became unbearable. She describes it as, like, this alien creature who's, like, trying to just claw its way out ...

SUMMER ASH: The bottom of my neck.

MOLLY: But there was this one moment. Right in the middle of all of this, she had her two-year checkup post surgery. And for that, they had to take a picture of her heart.

SUMMER ASH: So I schedule my two-year appointment.

MOLLY: And to look at her heart, they do an echocardiogram.

SUMMER ASH: Which is basically, you know, like the ultrasound, like, that you get for the pregnant.

MOLLY: Oh, like a wand?

SUMMER ASH: Yeah, it's like a little wand, and you get the jelly.

MOLLY: Oh!

JAD: Oh!

[laughter]

SUMMER ASH: And they basically go all over your upper—you know, the area around your heart, and from all different angles. So what ended up happening is I'm lying on my left side and I'm facing the wall, and the technician's behind me.

MOLLY: And the technician is sort of like, reaching around her, waving the wand over her heart. And the monitor for the echocardiogram is behind Summer so she can't see it, but she's wearing eyeglasses.

SUMMER ASH: So you know how you can sometimes, like, see a reflection peripherally on your glasses of something that's, like, behind you? Like, if you were in a somewhat darker room and there was a window, like, you would totally see the reflection. So the room's a little bit darkened.

MOLLY: Summer's lying there on her side, and she sees the reflection of the screen.

SUMMER ASH: On my glasses.

MOLLY: And it catches her eye because it's moving.

SUMMER ASH: And then I realize what it is that I'm seeing.

MOLLY: A tiny reflection of her heart beating.

SUMMER ASH: And I have this, like, moment. I have this moment where I'm like, "Oh my gosh! You're—" I'm, like, talking to my heart in my head, going, "Oh my God, you're working hard. Like, you're trying your hardest. You're doing the best that you can. I'm doing the best that I can, but you're in there, and you're working. And you are working for me, and we are on the same team." And I just totally—like, I just silently start crying.

MOLLY: Like, what do you think spurred that on? Like, what was it about seeing it, or ...

SUMMER ASH: There's just something about physically seeing it pump, and—but feeling it at the same time. Like, knowing that I'm seeing what's happening inside me, that somehow just, like, clicked this understanding into place.

MOLLY: She said there was something about seeing it in real time, like, feeling this thing in her chest just pulsing in rhythm with what was happening on the screen. And then suddenly, it just—it didn't seem separate from her anymore. And all those worries about the future and what was gonna happen and was it gonna go away and everything just stopped. She was just like, "No, you are just beating. And that beating is me."

SUMMER ASH: It was sort of—it was sort of like this moment of recognition of its purpose and its work, and sort of this—so it's kind of like that whole idea of when you feel like you see somebody, not just physically, like, you see who they are, you see what they are, but you see who they are. Like, I had that. Like, I felt like, "I see you, heart. Like, I see what you're doing. I see what your purpose is. I see you."

MOLLY: On the one hand, what she sees, like, with her engineer's brain, is, "Oh, I get you. You're just a pump." And it's that same, you know, realization that essentially led to modern medicine, right? Like, the minute we took the soul out of the heart, we were willing to touch it, to cut it open, to stitch it up, to start fixing things. And now we have lifespans that by some estimates are 2.5 billion beats. But on the other hand, like, when you hear someone's heartbeat—your parent's or your child's—like, in that beat is an entire lifetime. It's a history of beats, it's a series of beats yet to come. And I don't know, thinking about all that, I just sort of got walloped at the end of this interview when Summer asked us if we wanted to try and listen to her heart.

SUMMER ASH: Can we try that? Just see?

MOLLY: Do you want to?

SUMMER ASH: Yeah, I'll just move the mic, or I'll stand up or something.

MOLLY: So she stood up from her chair, and she sort of put her chest right in front of the mic. And then we all just got really quiet.

SUMMER ASH: Okay.

[heartbeat]

JAD: Oh my God!

MOLLY: Oh my God!

[heartbeat]

JAD: Oh my God. Wow!

MOLLY: It just makes me really emotional. Every time I hear it, it makes my eyes well with tears. [laughs]

JAD: That's really amazing.

SUMMER ASH: I guess I still got it.

JAD: [laughs] Good job, heart. You go.

MOLLY: Yeah.

JAD: So give it up for Radiolab producer Molly Webster.

[applause]

JAD: And give it up for Sō Percussion! Now when we said earlier that a lot of people in the audience had strong reactions ...

ROBERT: Mm-hmm.

JAD: Here's what we meant. I mean, I don't know if you could tune this in but, like, when we were doing that story, I was just definitely seeing, like, something's going on out there.

ROBERT: Well, I couldn't tell because we were on stage. I couldn't—you know, because there's 25 different people.

JAD: I definitely was tuning in. There's something going on in the audience, something going on sidestage.

ROBERT: Oh really?

JAD: But I didn't really know what it was. We were in the middle of it. Walk off stage, and the first thing we hear is that numerous people had fainted, even vomited during that piece. We were like, "What? Seriously?"

MOLLY: I did not see it coming.

JAD: No. We were really, really scared at first.

MOLLY: And I thought, "Oh, my God, am I killing people? What just happened?"

ROBERT: [laughs]

MOLLY: Oh, my—like, it was just like—I was like, were they old? Were they young? Like what—like, what?

ROBERT: And they were young, right?

MOLLY: They were young. And that made me, like, "Oh, okay." They feel, like, weirdly, a little bit better.

JAD: Because maybe they can handle it.

MOLLY: Yeah, I just was—and then I was kind of weirdly mortified, terrified.

JAD: Yeah. But after we figured out that no one was hurt, we were like—we got—we were like—we started putting out—we started making some calls because we were like, "What was that? What do we make of that?"

ROBERT: Wait a second. I didn't know you—so the show is over and we all go home.

JAD: So this is days after. This is days after.

ROBERT: And you're thinking, "Oh my God, we're gonna ..."

JAD: Yeah, because I'm thinking we've gotta podcast this damn thing, right? We have to understand this and say something.

ROBERT: Well, that's completely right.

JAD: So the first person we called was a psychiatrist.

RACHEL YEHUDA: Rachel Yehuda, Mount Sinai School of Medicine, department of psychiatry.

JAD: Explained to her the basic situation, that some people had fainted and felt woozy. We weren't quite sure how many.

RACHEL YEHUDA: Five or six people out of 2,200.

JAD: Somewhere between five and twelve. We don't have a clear number just yet.

RACHEL YEHUDA: That's very interesting.

JAD: Do you have any sense of what might have caused this? Just like a guess?

RACHEL YEHUDA: So my best guess about that would be that they have activated their parasympathetic nervous system in response to hearing the heartbeat.

JAD: Now just to explain, our autonomic nervous system is divided into a bunch of different parts. You've got your sympathetic nervous system, which is sort of your fight or flight.

ROBERT: Right.

JAD: So what turns on when you're scared. And then you got your parasympathetic nervous system, which is sort of the opposite. Rather than getting you ready to fight or run, it makes you calm. And Dr. Yehuda says that in certain people, that parasympathetic response can actually kind of go overboard and their blood pressure can drop quickly, too quickly, and they end up fainting.

RACHEL YEHUDA: Now the most common stimulus for this to happen in real life is fainting at the sight of blood. Some people just do that. And it's not that common. About two to four percent of the population have this kind of a response, and we don't exactly know why it happens. There is some opinion that the idea of fainting when you see blood is an adaptive, evolutionary response.

JAD: That, you know, maybe back in the day when we were being chased by predators, it would have been a good idea to faint.

RACHEL YEHUDA: Because maybe the animal will think you're dead.

JAD: And then he'll skip you.

ROBERT: He wants live meat and you're dead meat.

JAD: Exactly. He sees you lying there and he's like, "I don't want to eat that."

ROBERT: Don't eat that.

JAD: Another theory is—this is also an evolutionary one, is that if your blood pressure drops like it does when you faint, well, that kind of protects you a little bit, because you'll have less blood in your arms and legs. So if your arms and legs get bitten by a lion, say, then you're less likely to bleed out.

ROBERT: I see. So there's nothing juicy to suck on if your blood is not in your wing or your limb.

JAD: Yeah, basically. I mean, who knows? These are just stories, but going back to the two or four percent thing, we got to thinking, two to four percent of our audience that night would be—what did we decide, Molly? It was 40 people?

MOLLY: It would be 44 to 88.

JAD: 44 to 88 people.

MOLLY: Out of 2,200.

JAD: So we put out some emails, looked at the incident reports, and I think now we have identified how many. What did we get so far?

MOLLY: So for us, we've heard of maybe 10 or 11 at this point.

JAD: Ten or eleven. But I think that based on some of the stories that are coming in, that the number might actually be much higher than that.

MARIA CIVICO: Because it was ...

JAD: For example ...

MARIA CIVICO: It just manifested itself physically in a way that I could not have imagined would be the case.

JAD: This is Maria Civico, who actually works down the street from us for the company that makes Latino USA.

MARIA CIVICO: I was sitting in the front against one of the walls, but not right at the wall.

JAD: She says she was listening to the story. Everything was fine at first, but then, she says, as the beat kept going, she began to worry, "What if it never stops? What if someone ever gets away from it?"

MARIA CIVICO: And then the drumming got more intense, and it was just like, "Oh no! Oh no!" And it was definitely the sense of being trapped, that the thing that was giving her life, which was absolutely necessary, was also the thing that was tormenting her.

JAD: And she says as she was thinking about that, she just kind of got short of breath.

MARIA CIVICO: And so I looked at my husband and put my hands up like, "I gotta go." And he looked at me, he was like, "Are you all right?" And I was like—I shook my head like, no. And then I had the talk in my brain, like, "Okay, this is an intimate radio moment. You are right in the front area. If you get up, six people have to get up with you. What are you doing? You're ruining this for everybody. Just breathe and it'll be fine." And then the deeper I tried to breathe, the more anxious I sort of got. Like, "Oh!" And I had this fantasy of, like, standing up and doing, like, a "Wahh!" kind of look to wiggle it out of me, but I was like, that's just as disruptive.

JAD: [laughs]

MARIA CIVICO: I've just gotta suck it up. And so—oh geez, look at that. I'm having trouble breathing just thinking about it.

JAD: Oh my gosh. I don't want to put you back there.

MARIA CIVICO: No, no, no, no. I'm fine, I'm fine, I'm fine.

JAD: Okay.

JAD: That's why my hunch is that there might be a lot more than 10, because maybe a lot of people just sort of pushed through and didn't get up. It still felt weird. In any case, one of the most interesting things that we bumped into is that Dr. Yehuda told us it's very possible that the fainting and the wooziness ...

RACHEL YEHUDA: Could be some kind of an empathy response.

JAD: Really? In what sense?

RACHEL YEHUDA: Well, if you hear somebody's heart beating, and you're aware that that's what you're hearing, it might arouse a tremendous connection within you of hearing the very source of their life.

MARIA CIVICO: Yeah, I became her. I did. I just—I was there with her.

RACHEL YEHUDA: And it can really be a lot to take in, and you feel a little faint or emotional.

MARIA CIVICO: I just identified so much with somebody being trapped in their own body. It's like, she couldn't escape. It was beating in my chest. The drums, I felt were beating in my chest. And in my crazy fantasy, you know, maybe they were beating at the same rhythm.

MOLLY: One of the people that emailed after the live show said that he felt like his heart was trying to match her beat and he couldn't catch his breath.

MARIA CIVICO: I don't know. I don't know. It's never happened to me before now.

JAD: Wow.

JAD: I asked her in the end if she'd ever want to hear Summer's heartbeat again, and she said, "Oh, yeah." In fact, she said she was gonna listen to the story as soon as it was podcast, which is now, because now she's got all these questions like, was it the acoustics of the space, or the fact that she was with so many people? Or maybe it was the volume because it was pretty loud?

MARIA CIVICO: And will I feel the same when I hear it, you know, with my headphones on or, you know, while I'm driving? Will I have that feeling? So I had already decided that I was definitely gonna listen to it again.

JAD: We'll let you know what happens. Before we go to break, I just want to say that Sō Percussion, who provided all the music so far, they've just released an album called Music for Wood and Strings, written by Bryce Dessner of The National. This is what you're hearing. It's kind of an amazing piece. If you want to check it out, go to sopercussion.com. We'll also link to it from Radiolab.org.

[LISTENER: This is Charlie from Brooklyn. Radiolab is supported in part by the Alfred P. Sloan foundation, enhancing public understanding of science and technology in the modern world. More information about Sloan at www.sloan.org.]

JAD ABUMRAD: Hey, I'm Jad Abumrad.

ROBERT KRULWICH: I'm Robert Krulwich.

JAD: This is Radiolab.

ROBERT: And we're back now. Going to take you back live on stage at the Brooklyn Academy of Music.

JAD: In this next story, you'll hear some references to some pictures which obviously you won't be able to see, but we've got them for you at Radiolab.org.

ROBERT: So we want to finish tonight with a salute to a guy who's been on our program and part of our program pretty much from the beginning. I have known him for more than 35 years. Early on when Radiolab started, I asked him if he'd help us out and send us a few story ideas. He didn't send us a few, he sent us bushels, tales of chemistry and medicine, hallucinations, music, people, so many extraordinary people that he knew or found or helped. Because the guy just doesn't run out. Dr. Oliver Sacks, neurologist, author.

[applause]

ROBERT: He's a guy who notices everything. He's deeply interested in everything that happens around him and to him. And tonight, we're bringing him back on tape for what, alas, may be his final offering for us. As many of you know, Dr. Sacks recently was diagnosed with liver cancer, and he wrote about this in the New York Times. He said he plans to spend the time that he has left writing, being with friends, not doing interviews. But he did agree to share his thoughts exclusively with us tonight, for you gathered here, because he's one of our family.

ROBERT: So as I've done for decades now, I went over to his house in Manhattan with my mic, and I said to him ...

ROBERT: I just need to know what—what just happened. A month and a half ago you were fine, and then what?

OLIVER SACKS: At the beginning of the year, I was fine. On the 3rd of January, I felt a little queer and I passed some dark urine. I thought I had a little gallbladder attack and didn't pay that much attention, but thought I'd better get things checked. And the x-ray, which was expected only to show a couple of gallstones, showed hundreds of cysts in my liver. Although my doctor said he didn't know what these were and I would need further tests, I knew what they were. I said, "It's happened."

ROBERT: And he was right. The doctors eventually confirmed that a cancer that had been found in his eye nine years ago had spread to his liver

ROBERT: Were you frightened or relieved or consoled? Or what?

OLIVER SACKS: No, I think my first feeling was one of overwhelming sadness. There are all sorts of things I won't see and I won't do. One or two people have written to me, you know, consoling me, and said, "Well, we all die." But fuck it. It's not like, "We all die." It's like, "You have four months."

ROBERT: Has that—what is your prognosis at this moment? Because I know you had an ...

OLIVER SACKS: Well, it gets revised.

ROBERT: It depends, of course, on how the cancer responds to treatments, or how quickly it spreads.

OLIVER SACKS: So far, the metastases from my eye are only in my liver. I'm told they love liver. Actually, I love liver as well.

[laughter]

OLIVER SACKS: And one of the magical things I did was to go and have liver and onions soon after the diagnosis.

ROBERT: Oh, wow!

OLIVER SACKS: And thinking, "That liver looks better than mine, probably."

[laughter]

ROBERT: [laughs] See? This is what he's like. Instead of being frightened by the thing that's trying to kill him, he's thinking about loving liver and liver lovers, and looking for connections and wondering. He doesn't stop. He just notices it. Case in point, a few months ago his doctor said to him, "We're gonna run a line up your liver, and in effect, we're gonna try to shave off or starve some of the cancer cells, first on one side, then on the other, to see if we can give you a little more time." But they warned him ...

OLIVER SACKS: As the metastases die ,they put out various unpleasant chemicals.

ROBERT: That may exhaust you, tax your system badly.

OLIVER SACKS: And at one point ...

ROBERT: Shortly after the procedures.

OLIVER SACKS: ... I started talking a little strangely. And as I was talking, I was also writing. You will be the first person to see this.

ROBERT: So he showed me a notebook—and we're showing it to you in just a moment. You can see there is writing there on the left. He's writing a book, actually, a children's book about the elementary table, but as he was writing, if you look to the next page, if you can see that, it gets a little bit wobbly, the letters.

OLIVER SACKS: And then there was some crossing out there.

ROBERT: Yeah, I see the crossing out.

OLIVER SACKS: And then rather dramatically the writing changes.

ROBERT: Actually, there's a large slash across it and then it seems a little incoherent at the bottom.

OLIVER SACKS: Yes. Okay.

ROBERT: And then it turns to pure scribble.

OLIVER SACKS: That is delirium. It crept up on me. All this happened in the course of 10 minutes.

ROBERT: You see what he's doing here. He's figuring, "Okay, I'm writing at a constant speed. I know pretty much how fast I write, and so I can time this out. I can figure out exactly how long it took me to slip into delirium, and then out of this delirium." And he's doing this as a very, very sick man, "It's science all the time!"

OLIVER SACKS: If I had to write it out in a more medical way, I think this would form a lovely illustration. You put on a timeline of delirium, just coming like that.

ROBERT: Why aren't you more frightened? Like, unusual for any doctor and a man of science, you don't seem to worry at all when things become incoherent or strange. You're now showing it to me as it's like, "Ooh, how interesting? I was crazy here for a little bit."

ROBERT: The truth is, Oliver is fascinated by what goes on in the human mind, no matter how strange it gets up there. And one time when he was a young resident in California driving his bike—and by the way, I should show you what he looked like back then when he was driving his bike. This, I think, is him in New York, a kinda—you know?

ROBERT: In the '60s, he was also a champion weightlifter. They called them Dr. Squat. And in this picture that I'm showing you here, that's him raising 600 pounds in order to win a trophy. Like, this is a—he was a champ. And you can see more pictures like these because we have signed copies of Oliver's new memoir out for sale in the lobby. It's a pretty good book, too, by the way. So in any case, at this time in the 1960s, in addition to being all muscled out, Oliver was a serious recreational drug taker. And because he's Oliver, he was extremely curious about his highs, no matter how weird they were. One time, for example, he took 20 pills that he shouldn't have.

OLIVER SACKS: And then to my surprise, there was a spider on the wall which said, "Hello." It had a voice like Bertrand Russell.

ROBERT: A famous mathematician.

OLIVER SACKS: And it asked me a rather technical question as to whether Russell had exploded Frege's paradox. And we had this conversation.

ROBERT: You answered the spider?

OLIVER SACKS: Sure, I answered the spider.

ROBERT: You discussed Frege's paradox with the spider?

OLIVER SACKS: I did indeed. Because you trust your perceptions.

ROBERT: Okay.

OLIVER SACKS: Many years later, when I mentioned this to an entomologist friend at Cornell, the philosophical spider, he said, "Yes." He said, "I know the species."

[laughter]

ROBERT: So thinking Oliver's way, taking it all in, talking spiders, whatever, the generosity of his curiosity becomes profoundly moving and transformative when he's treating his patients. I want to tell one story here really quickly to demonstrate what I mean. Oliver once had a patient whom he called Mrs. OC. She was an old woman. She was 88 years old, living in a nursing home. And one night she was awakened, jarred awake by a loud sound.

[music]

ROBERT: It was a song. And she thought, "Well, somebody's left the radio on." But when she looked, the radio in the room was off, her roommate sound asleep, which was odd because the song was really loud. And after that, it was another song, and then another song.

ROBERT: And this is what she thought: "Well, maybe my roommate can't hear these songs because the songs are coming through the fillings in my teeth. I've heard that's possible." But no, her doctors told her, "This is something in your head. You need to see a neurologist." Which led her to Dr. Sacks. Now when he met Mrs. OC, she could barely hear him, the songs sung by the female voice were coming and coming. She was frightened and justifiably worried that she was going crazy. But Oliver said, "No, no, no. I'm gonna do some tests." And when he was done, he said he'd found a slight stroke or condition that had triggered 'musical epilepsy,' the sudden production of music in her brain. Now a normal doctor might say, "Okay, we've got the diagnosis," and he thought that the songs would probably fade and it would pass so they would be done. But Oliver did not stop. He doesn't stop.

ROBERT: He kept talking to her. She told him she was born in Ireland in the 1890s. Her father died before she was born, her mother when she was only five.

OLIVER SACKS: Orphaned, alone, she was sent to America to live with a rather forbidding maiden aunt. She had no conscious memory of the first five years of her life—no memory of her mother, of Ireland. She had always felt this as a keen and painful sadness, this lack of forgetting of the earliest, most precious years of her life.

ROBERT: So he asked her about the songs. "What are they like?" And Mrs. OC said, "Well, I think they're lullabies." "Can you sing them for me?" She did. And then after checking with—and I'm not sure who—Oliver figured out that these songs happened to be popular Irish ballads from the 1890s when Mrs. OC was a little baby. And that gave him an idea. Now what he does next isn't science. It isn't in any traditional way medicine. He just told her a story, and it goes like this. You know how nobody remembers anything that happens to you when you're one or two or three? Well, there was a theory once, not honored much today, but it said that those earliest memories get locked away deep in our brains in a special safe that we can never open. "So let's suppose, Mrs. OC, that your stroke by some crazy chance opened the lock that none of us can break and released those first memories in you, just for a little while. So that the voice you're listening to ...

[music]

ROBERT: ... maybe that isn't a radio voice. Let's say that it's your mother's voice. That's your missing mother. And so at the ripe old age of 88, you finally get to be back in your mother's arms. You get to be a baby again." And Mrs. OC thought about that and said, "Okay, it sort of fits."

OLIVER SACKS: "I'm an old woman with a stroke in an old people's home, but I feel I'm a child in Ireland again, I feel my mother's arms. I see her, I hear her voice singing.

[music]

ROBERT: Shortly thereafter, the songs began to fade, the pauses widened. Mrs. OC, who had been so frightened by this music in her head was now sorry to see the songs go. But it was Oliver who noticed how those songs had touched her, who noticed that the songs might become a comfort to her because that's what he does. He listens closely. He can hear another person's heart.

ROBERT: And this is really the profound puzzle for me of Oliver, because reading the new autobiography, you see that while he was so full of heart as a doctor in his own life and in the relationships that really mattered, it turns out he didn't get a whole lot of affection. He was for a long time, a lonely guy. I'd say he was very lonely. And he's talking about that now for the first time.

ROBERT: Let me talk about love for a minute. In this book, you tell the story of your very first love, a fellow by the name of Richard Selig. Can you just tell me what happened with him?

OLIVER SACKS: Yeah. He was a Rhodes scholar at Oxford, and a poet. And handsome and beautiful beyond belief. And I sort of fell for him, although I didn't say anything because I was very haunted by my mother's accusations.

ROBERT: What did your mother ...

OLIVER SACKS: Well, to go a couple of years back then, my father had opened a conversation that I was about to go to Oxford, a sort of father-son conversation. He said, "You don't seem to have many girlfriends." And I said, "No," wishing the conversation would stop. He said, "Something wrong with girls?" I said, "No, they're fine." "Perhaps you prefer boys." And I said, "Well, yes I do." I said, "I've never done anything, but I do." And ...

ROBERT: And you knew that then?

OLIVER SACKS: I knew that then. I had known it for six years, probably. Since I was 12. And I said, "Don't tell Ma. She won't be able to take it." But my father did tell my mother in the night, and the next morning she came down with, I somehow want to say a face of thunder and raged at me. And among other things said, "You're an abomination. I wish you had never been born." And then she suddenly shut up and said nothing for three days. And the matter was never mentioned again in her lifetime. And then two years later, I found myself for the first time in my life falling in love.

ROBERT: And this was the young guy, Richard. Oliver at the time was in college.

OLIVER SACKS: It was a very positive feeling, though I didn't know whether it was one which I dared express. But I did say so with my heart in my mouth to Richard.

ROBERT: What did you—do you remember what you said?

OLIVER SACKS: I said, "I'm in love with you." And Richard gripped me by the shoulders, and he said, "I know." He said, "But I'm not that way, but I love you in my own way." And I was glad I had said it. I'm glad that it had been received in such a warm, friendly way. I thought we might be friends for the rest of our lives, but then one day he came in to me. He said he'd been bothered by finding a lump in his groin.

ROBERT: And he was worried.

OLIVER SACKS: Could I have a look at it? And I looked at it and I felt it, and it was hard and tethered. It turned out to be a particularly malignant form of lymphoid tumor, what was called a lymphoma sarcoma. And he never spoke to me again after that. I don't know whether, since I'd been the first to recognize the ominous import, I don't know whether he saw me as a harbinger of death or a messenger of death, whatever.

ROBERT: But you were left with that silence?

OLIVER SACKS: Yeah.

ROBERT: Yeah.

ROBERT: A few years later, Oliver met a man named Mel. He was young, he was a sailor. Like Oliver, he was into weightlifting. They became close friends, and they began living together.

OLIVER SACKS: I adored him and was in love with him, and loved physical contact with him.

ROBERT: And they'd work out and they'd wrestle and ride motorcycles kind of tightly, and they never talked about what might or might not be happening between them. But one day they were together, and Oliver was giving Mel a back massage, which Mel often asked him to do.

OLIVER SACKS: And I loved doing that.

ROBERT: And Oliver says, sometimes he'd get a little, you know, excited.

OLIVER SACKS: And so long as I gave no explicit indication, it was okay. But one day, things went a bit too far and I got sort of—I went over the brink instead of just before the brink. Mel immediately sort of got up and had a shower and said, "I can't stay with you anymore." And I found that very cruel and upsetting and heartbreaking. And it made me feel I don't want to have anything to do with people. I mustn't fall in love. I cannot share lives with anyone again.

ROBERT: And he didn't share his life with anyone for a long, long time. In fact, he told me a story about something that happened to him maybe eight years ago.

OLIVER SACKS: I was just joining the faculty at Columbia, and I was having a sort of an interview. And at one point, the interviewer said to me, she said, "I have something rather private to ask you. Would you like Miss Edgar, your assistant, to leave?" And I said, "No, she's privy to all my affairs." And I then said, thinking she was going to ask me about sex, I said, "I haven't had any sex for 35 years."

ROBERT: [laughs]

OLIVER SACKS: In fact, she was going to ask me my social security number.

[laughter]

OLIVER SACKS: And she burst into laughter. She said, "Oh, you poor thing!" She said, "We must do something about it."

ROBERT: Well, the truth is Oliver didn't do anything about it because he didn't think he could. I mean, he'd chosen Richard, lost Richard, chosen Mel, lost Mel. There wasn't a point, he was thinking. And then finally—and who knows when or why these things happen to people, but a man came along who for the first time chose Oliver.

OLIVER SACKS: I had met Billy as I meet a number of people because I'd been sent a manuscript or a proof for a book. And an intimacy grew between us. I don't think I quite realized how deep it was, but then there was a particular episode in Christmas of '09 when he came up and in a sort of serious way he has, a serious careful way, he said, "I have conceived a deep love for you."

ROBERT: I have conceived a deep love for you?

OLIVER SACKS: Yes.

ROBERT: That's got a few extra words. "I have conceived ..."

OLIVER SACKS: Yes. Right. Okay

ROBERT: Was he scared to say, "I love you?"

OLIVER SACKS: No, he likes the English language.

[laughter]

OLIVER SACKS: I think it couldn't have been put more cautiously and yet more strongly. I think it was a beautiful way of putting it, and then I realized at that moment with his saying that I had conceived a deep love for him. And I—among other things, I thought, "Good God, it's happened again. And I'm in my 77th year."

ROBERT: That's amazing. 77.

OLIVER SACKS: "And what next?" And things basically have gone happily ever since. And surprisingly guiltlessly because then again, I'm not dealing with a 'what,' I'm dealing with a 'who.' I'm dealing with an individual. I'm not dealing with a condition defined by medicine or law.

ROBERT: So Oliver still doesn't know how much time he has left, but for the moment, as you can hear, his mind is totally intact. He's still writing. He has two books in addition to the one you'll find in the lobby that he's writing. And the children's book, a bunch of New Yorker stories in the last few months, and a New York Review of Books story. He's got energy to spare. So I want to do one last thing before we close. And this comes from yet another conversation I had with him. And it's a story I know Oliver would hate because he's not a capital-R "Religious" kind of guy. But he is somebody who definitely embraces mystery. And for a long time, he's been mystified by a color called indigo.

OLIVER SACKS: Indigo, which Newton had inserted between blue and violet. And no two people seem to agree as to what indigo was like. And so I built up a sort of chemical launchpad.

ROBERT: Meaning he took a lot of drugs.

[laughter]

OLIVER SACKS: A base of amphetamine for general arousal, then some acid and a little cannabis. And when I was sufficiently stoned, I said, "I want to see indigo now." As if in reply and as if thrown by a giant paintbrush, there appeared a huge trembling pear-shaped blob of what I instantly realized was pure indigo on the white wall in front of me. It had a wonderful luminosity. And in particular, although I am not a religious person, I thought, "This is the color of heaven." And I leaned towards it in a sort of ecstasy, and then suddenly it disappeared.

ROBERT: And he says he had one more moment like that—this time no drugs. He was in a museum, staring at an Egyptian artifact. He sees this brilliant color back again, just for a beat.

OLIVER SACKS: I was given five tantalizing seconds of radiant, ineffable beauty.

ROBERT: And then, again, it vanished.

OLIVER SACKS: And that was in 1965, and I've never seen indigo since.

ROBERT: But who knows, you know? Someday, I like to think Dr. Sacks may get to see that color again.

[applause]

[music]
ROBERT: That was the remarkable Sarah Lipstate, also calls herself Noveller. That was her own composition. And a special thanks also to Josh Higison and Keith Scretch who mounted this whole show with no time and extraordinary ingenuity.

JAD: Yeah. And certainly a huge, huge, huge thanks to Ellen Horne who carried the load on this thing, man!

ROBERT: [laughs] Yes, she did.

JAD: Nikki Capper.

ROBERT: And Kate Edgar.

JAD: Ben Cohen.

ROBERT: And Nadia Sirota.

JAD: Everybody at BAM, especially Nick Schwartz-Hall, Barbara Walstein.

ROBERT: Tess James.

JAD: And all the folks at So Percussion: Eric Cha-Beach, Jason Treuting, Adam Sliwinski, Josh Quillen.

ROBERT: Special thanks to Yumi Tamashiro.

JAD: She's the production manager.

ROBERT: She's the production manager.

JAD: Thanks also to WNYC's recording engineers: Edward Haber, George Wellington and Noriko Okabe. And thanks also to Eva Dasher. I'm Jad Abumrad.

ROBERT: I'm Robert Krulwich.

JAD: Thanks for listening.

 

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