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Sacks never married and lived alone for most of his life. He declined to share details from his personal life until late in his life. He addressed his homosexuality for the first time in his 2015 autobiography On the Move: A Life. During his early career he indulged in:

"staggering bouts of pharmacological experimentation, underwent a fierce regimen of bodybuilding at Muscle Beach (for a time he held a California record, after he performed a full squat with 600 pounds across his shoulders), and racked up more than 100,000 leather-clad miles on his motorcycle. And then one day he gave it all up-the drugs, the sex, the motorcycles, the bodybuilding."

Celibate for about 35 years since his forties, in 2008 he began a friendship with writer and New York Times contributor Bill Hayes, that evolved into a committed long-term partnership in a shared home. He noted in a 2001 interview that severe shyness-which he described as "a disease"-had been a lifelong impediment to his personal interactions.

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