ON THE MOVE: A Life, by Oliver Sacks. Alfred A. Knopf, 387 pp., $27.95.

It's hard to imagine the nonfiction of our era without the life-affirming work of Oliver Sacks, whose "clinical tales" combine close scientific observation with extraordinary compassion. These are not so much accounts of neurological syndromes, but vivid stories of human beings in all their endless variety. From "Migraine" to "Awakenings" to "The Man Who Mistook His Wife for a Hat" and more, he has acquainted readers with as much beauty as pain.

Now 81 and dying of cancer, Sacks has written a memoir. "On the Move," his most intimate book, is passionate about many things -- motorcycling and weightlifting, science and medicine, family and friends. It is also remarkably candid about his homosexuality and a onetime four-year addiction to amphetamines.

StoryBook excerpt: 'On the Move'

Who knew that Oliver Sacks, anointed by Queen Elizabeth a Commander of the British Empire in 2008, was once the sort of young dude pictured on the book's cover: buff and strikingly handsome, leather-jacketed, astride a motorcycle?

In the memoir "Uncle Tungsten," Sacks reported on his burgeoning fascination with science during childhood. The new book moves on to his adult years. After university at Oxford, it jumps to the United States, his home since 1960, as his base shifted from San Francisco to Los Angeles and, in 1965, to New York.

Sacks' motorcycle adventures -- one an 8,000-mile trek around the continent -- put him into such "magical, dreamlike" trances that he and his bike would become fused into "a single, invisible entity."

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Other '60s trips -- via pot, LSD and other hallucinogens -- took him to other destinations, which he does not regret. The "thrall" of amphetamines was another story, inducing not only ecstasy but heart rates and blood pressure pushed to "lethal heights." Once he got to New York and decided he needed help, his shrink refused counseling until he got the monkey off his back. Without saying how, he managed to do so.

As a weightlifter, Sacks bulked up enormously, at one point reaching 250 pounds. He could lift more than twice that. At Muscle Beach, near L.A., he was dubbed "Dr. Squat," for the mighty weight he could raise while rising from squatting to standing.

For the first time, I believe, Sacks is open here about his homosexuality. Coming out to his mother, while at Oxford, was painful; She blurted out that she wished he'd "never been born." But this woman, born to Orthodox Jewish parents in the 1890s, later made up for it by doting on him. Her death in 1990, Sacks writes, was "the most devastating loss of my life."

No gay Lothario, Sacks proved uncomfortable and shy in gay bars. He had an unfortunate tendency, too, to fall for straight guys. From age 40 until recently, he reports without explanation, he remained celibate. Love seemed perpetually beyond reach.

Meantime, engagement with the mysteries of neurology sustained him. His patients suffered from post-encephalitis syndrome, Tourette syndrome, autism and other brain anomalies, but they were never merely case studies. In his eyes, each was "vividly alive, interesting and rewarding; I have never seen a patient who didn't teach me something."

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Sacks' bosses at hospitals and clinics in the Bronx regarded him as a maverick, because he got too close to his patients and argued against arbitrary rules. He, in turn, considered some of his superiors morally reprehensible, because of their "complete subjugation of the human to medical arrogance and technology." Fired several times, this self-described "gypsy" never enjoyed stable, long-term employment.

Even while publishing highly praised books, Sacks remained a pariah within certain medical research circles. Critics chided that his stories, not based on extensive data, amounted to useless anecdotal evidence. Yet scientists such as Francis Crick, co-discoverer of DNA, defended his brilliant deductions that pointed the way to further brain research. Closer to home, his beloved Aunt Lennie cheered him on when his self-assurance faltered.

Learning to come to terms with unique patients has given Oliver Sacks permission to come to terms with himself. And what a self this book reveals! A man animated by boundless curiosity, wide-ranging intelligence, gratitude for flawed humanity, perseverance despite setbacks.

In an essay published this February, Sacks divulged that cancer would end his life within months. Even so, he wrote, "I feel intensely alive." And at the heart of his thoughts was every person's distinctive essence: "When people die, they cannot be replaced. They leave holes that cannot be filled."

Oliver Sacks can never be replaced. We're lucky to have all the books, including "On the Move." It's intensely, beautifully, incandescently alive.