In Memoriam, Epilogue: The Psychiatrist Who Mistook Oliver Sacks for a Psychiatrist Confesses
Key Takeaways
- Oliver Sacks' journals revealed fabricated case studies, challenging his literary and medical integrity.
- Rachel Aviv's expose raises questions about the balance between narrative and scientific accuracy in medical literature.
Exploring the complex legacy of Oliver Sacks, this article examines the blurred lines between truth and fiction in his case studies.
PSYCHIATRIC VIEWS ON THE DAILY NEWS
Yesterday, I wrote my
Back on September 1, 2015, as requested, I did one of my psychiatrist eulogies on Oliver Sacks. No, he was not a psychiatrist, not even a neuropsychiatrist, but he seemed close enough for me to write the eulogy titled: “Oliver Sacks: A Neurologist Who Could Be ‘Mistook’ for a Psychiatrist.”1 I pointed out what I thought reminded me of his being like a psychiatrist:
- He seemingly dealt well with death anxiety, including writing a series on his terminal illness for the New York Times.
- He established positive therapeutic alliances with what seemed like careful and humane evaluations of unusual patients, as depicted in his best-selling book, The Man Who Mistook His Wife For a Hat.
- He seemed to value self-analysis like Freud, as in his books, Hallucinations and On the Move: A Life.
Despite his continuing renown at the time of his death, I closed with some questions:
- “Did he exploit some of his patients for his writing?”
- “Did he pay too much attention to their literary presentation rather than a drier scientific analysis?”
- “Were the titles of his books too cute?”
As the years went by, I assumed the answers for those questions were: no, no, and no.
However, about a month ago, on December 8, 2025, the answers seemed to be turned on their head: yes, yes, and yes. Rachel Aviv wrote an expose on him in the New Yorker titled “Oliver Sacks Put Himself into His Case Studies: What was the Cost?”2
The truth was apparently found in his journals, which were provided to Aviv by the Oliver Sacks Foundation. In them, he admitted that his cases were fictitious, and to a degree more expansive than hiding patient identities in case studies to preserve confidentiality. His self-described guilt seemed to increase as he wrote:
“Guilt has been much greater since Hat because of (among other things) my lies, falsifications.”
Maria Konnikova followed all this up in her December 16, 2025, Substack column titled: “The man who mistook his imagination for the truth.”3 Rather than now sounding like a psychiatrist, he sounded like a psychiatric patient:
“These old Narratives - half-report, half-imagined, half-science, half-fable, but with a fidelity of their own - are what I do, basically, to keep my demons of boredom and loneliness and despair away.”
Aviv had noted that he seen a psychotherapist for 50 years, so maybe he sounded like a psychiatric patient because he was one. If his therapist knew he was lying, perhaps the therapist fell back on our confidentiality ethical principle that the harm to others was not too great. But maybe it was because such popular writers like him and Aviv are read and discussed by so many outside of formal psychiatry.
By consensus, his writing was beautiful, but misleading medically. Perhaps he was ahead of time with his use of alternative facts.
After reading Aviv’s article, by extension, I wondered if hers was adequately truthful. I found that Marco Roth, on September 5, 2022, in Tablet magazine, wrote the article “Rachel Aviv’s Journey to the Ends of Psychiatry.”4 Her own journal went from being diagnosed with anorexia nervosa at a very young age to replace Janet Malcolm’s unofficial position of “psychoanalysis and psychiatry correspondent” for the New Yorker. She wrote her own book of a series of case studies called, Strangers to Ourselves: Unsettled Minds and the Stories That Make Us. She uses many sources of information, though that still must be selective and interpreted. She criticizes the goal of “insight” in psychotherapy. Others have written about pharmaceutical companies controlling double blind medication trials in their favor.
I must admit that in my eulogies, I go for the positive like I have seen clergy do. I certainly did so with Oliver Sacks, though perhaps unwittingly.
In literature, we must remember poetic license may be present. Sacks could be said to have written historical fiction, and if so, said so. In actual treatment, placebo probably plays a bigger role than we usually admit. In so many columns, I have decried the lack of attention to social determinants of mental health and illness. All aspects of our bio-psycho-social model seem to have been compromised in Dr Sack’s literary productions. As is addressed in cultural psychiatry, a strong dose of humility is in order.
Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.
References
1. Moffic HS. Oliver Sacks: a neurologist who could be ‘mistook’ for a psychiatrist. Psychiatric Times. September 1, 2015.
2. Aviv R. Oliver Sacks put himself into his case studies: what was the cost? New Yorker. December 8, 2025. Accessed January 13, 2026.
3. Konnikova M. The man who mistook his imagination for the truth. Substack. December 15, 2025. Accessed January 13, 2026.
4. Roth M. Rachel Aviv’s journey to the ends of psychiatry. Tablet. September 6, 2022. Accessed January 13, 2026.
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