In the early 1980s, Lawrence Weschler, then a staff writer for the New Yorker, visited the not-yet-famous neurologist Oliver Sacks—future author of Awakenings, The Man Who Mistook His Wife for a Hat,and many other titles—at his home on City Island in the Bronx, angling for his next magazine profile. Weschler spent four years with the endearing, complicated Sacks preparing for the piece—going on rounds with him at a rehabilitation center in the Bronx, touring museums, dining at restaurants and at Sacks’ home, philosophizing at length, and taking a few rowboat tours of Long Island Sound. Ultimately, Sacks, beset by internalized homophobia, couldn’t bear such a public coming out in a New Yorker profile, and he asked Weschler to shelve it. Decades later, when he was terminally ill, Sacks asked/implored Weschler to write the piece, resulting in the recently published And How Are You, Dr. Sacks? A Biographical Memoir of Oliver Sacks (Farrar, Straus and Giroux).

The memoir—witty, intimate, erudite—earned a Kirkus Star; our reviewer calls it “a dazzling portrait of a ‘graphomaniac,’ a ‘grand soliloquizer,’ an ‘unparalleled clinician,’ a ‘studiously detached naturalist,’ prodigious swimmer, weight lifter, and reckless motorcycle speed demon.” Here we talk with Weschler, author of many books and the director emeritus of the New York Institute of the Humanities, about the pioneering thinker who became a lifelong friend.

What’s with the title of your book?

Well, during the four years I spent most intensively with Oliver, during the early ’80s when I was preparing to write one of those multipart profiles of him for the New Yorker, he used to describe himself as a clinical ontologist, by which he meant a doctor for whom the diagnostic question, faced with each fresh patient, was “How are you?” Thirty-five years later, when Oliver, as he was dying, ordered me to return to the project, I effectively decided to turn the question back on him.

Why didn’t you write the piece back then, 35 years ago?

Because after all that reporting, Oliver asked me not to. Deeply closeted and all knotted up with self-loathing over the fact that he was gay—even though the virtual entirety of his experience of that life had been 15 years earlier, when for a few years he threw himself deeply into a leather-, motorcycling-, bodybuilding-, tremendously drug-infused scene, and he had been resolutely celibate ever since, as he would continue to be for the next 20 years—he asked if there was any way I could fashion my profile of him without referring to what he considered the very blight of his existence. And I said really not. I’d come to feel that his gay years, his tortured attitude regarding those years, and especially the sheer extent of the accompanying drug experiences, were central to how he was, helping to account for the preternaturally layered empathy and openness he, and often he alone, subsequently seemed capable of lavishing on the sorts of utterly ignored and overlooked in extremis patients he came to focus upon, starting with the cohort of Awakenings patients whom he’d featured in his masterpiece of 10 years earlier. At any rate, of course I acceded to Oliver’s wishes and abandoned the project (we remained dear friends; he even became a doting godfather to my eventual daughter) and only returned to it during the last months of his life, when he virtually ordered me to.

But wait a second, wasn’t he living in New York and virtually within a few blocks of the Stonewall Inn when the upraising occurred?

Indeed, but as it happens, that summer of 1969 was the very season when the Awakenings drama was coming to a head up at Beth Abraham [Center for Rehabilitation and Nursing] in the Bronx; he was spending almost all of his time there and probably didn’t even notice events back there in the Village. Beyond that, his homophobic self-loathing was very deep-seated in him. Keep in mind, he had come of age in the very England and at the very time when no less a genius than Alan Turing, for example, was being chemically castrated for being gay. And in Oliver’s own case, his mother, one of England’s first female surgeons, with whom he had been exceptionally close throughout his upbringing, fell back on her own Orthodox Jewish formation when she found out about Oliver’s yet-to-be-acted-upon proclivities when he was 21. She came storming down the stairs and tore into him, casting “Deuteronomical curses” as he used to characterize them—filth of the bowel, monstrous perversity, “I wish you had never been born!”—and that was the voice Oliver initially fled from, to California, but never really escaped.

Never?

Well, actually, seven years before he died, he finally relented, allowing himself to fall in love with a wonderfully sweet-natured, sensitive, and supportive younger man—the writer Billy Hayes—and Oliver’s final decade was in fact doubtlessly his most blessed. He even ended up writing an autobiography in which he outed himself!

And how does that book compare with yours?

Well, in this regard, he deals with those issues from a position of serenity—thank goodness—whereas my account focuses on a time when he was in the midst of a huge decadelong writer’s block and massively, often hilariously, neurotic and bollixed up. A friend describes my account as “a picaresque romp,” and through much of it, I am very much a beanpole Sancho to his capacious Quixote. But I hope it also captures the pathos and some of the depths of his struggles as a person and as the eminent doctor—a neurologist of the soul, of the individual who had the condition rather than the other way around—that he was fast becoming.

Karen Schechner is the vice president of Kirkus Indie.