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Awakenings

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Oliver Sacks has elevated the case history in Awakenings to a literary art form of the highest kind. A neurologist in charge of a ward of people left high and dry by the 1918 flu epidemic which left them in a profound catatonic state, an extreme form of Parkinson's, he experiments on his patients with a new wonder drug L-Dopa which proves a mixed blessing for them. Some are awakened to brilliant life for a brief time, but most of them are doomed either to revert to their original condition or to die (several know they are going to die and announce the fact). Dr. Sacks (who looks quite demonic on the cover photo) uses his medical powers to change lives with a high-handedness that is almost Faustian. The effects are so extraordinary and strange that some of these stories read like the finest fantasy. All the stories are wonderfully strange, proving that human consciousness is many-faceted and that what we label "disease" may be merely a new avenue of perception. Some of these people perform acts not only bizarre but improbable, showing an unusual level of vitality and no ordinary degree of power. There are people here able to fill whole buckets with their saliva, people who rise from beds they have not left for 30 years with no muscle atrophy, people whose extraperception provide them with a life invisible to others, people who fall into pits unseen by anyone else in a perfectly ordinary hospital hall, unless securely in contact with others, people who can only move "normally" to music, people occupying a strange anachronistic limbo, stuck in the time when they first fell ill, and people who move as slowly as plants grow, whose time sense is distorted so that they seem motionless as statues for hours of a time arrested in mid-movement, though in their own perception, they are completing an activity (brushing their hair) at an ordinary pace. This is Sack's greatest work, a riveting portrait of human possibilities at their most extreme.

If I had never read "The Man who Mistook his Wife for a Hat" before this book (both by the same author), I would have rated this as a five-star classic. Though as well written as the other work, this book presents his studies in a less humane, and more scientific way. Read the other work and one will sense the noticeable difference in the way that Dr. Sacks approached his patients. When reading the "Awakenings", I felt as a detached bystander looking through the windows of his clinic and observing the patients. When reading "The Man who Mistook his Wife for a Hat", I was so engaged by Dr. Sacks vivid descriptions of the patients, physically, intellectually, emotionally and spiritually, that it was as if I was face-to-face with the patients, and that I was connected in some intrinsic way to each and every one of them. Please please read the other work as well as this one.

Despite flaws, one of the most human books I've read

In 1969, Oliver Sacks gave L-DOPA (a recently released "miracle drug") to scores of his post-encephalitic Parkinson's patients. Most of them woke up - after essentially being in a state of sleep/death for over 30 years. They were the remnants of the great post-WWI epidemic and most spent virtually all their adult lives institutionalised. They were suffering from a specific "flavour" of Parkinsonism - and contrary to popular belief, this disease is not about shaking or tremors but more about the warping of an internal sense of scale (of space and time) which makes movement, thought and being human almost impossible. L-DOPA gave the patients a new lease on life, but at a terrible price.

The book chiefly outlines the case histories of individual patients in the course of the treatment. Although occasionally Sacks is repetitive from one patient to another (one of the book's flaws), his attention to detail, his degree of empathy and the vividness with which he describes the patients and their lives are breathtaking. The book gives an amazing impression of what it's like to go from being at a standstill (your mind being taken up by a map of a map of a map of a map...of nothing) to the frenzy of mania (one patient spoke at 500 words a minute).

Awakenings has inspired a Hollywood movie, dozens of plays, documentaries, theatrical productions and more. This is because the story is about so much more than a particular disease. It's about what it means to be human. And it's about the tremendous strength of the patients in the face of a disease that has to be read about to be believed - literally a living hell. Although Sacks seems almost mystical-dualist at times (the other main flaw in my opinion), his purpose is to bring the story to the world and to encourage a more wholistic, empathetic medicine that does not aim to reduce the human to symptoms and side effects, especially when it's completely counterproductive for certain disorders.

Very recommended despite some minor flaws.

One of the things I find most striking about Oliver Sacks is his humanity. I find myself instilled with his sense of compassion and understanding by reading his cases.

Awakenings succeeds at being accessible to both the layperson and professional, and captivating both. There is a glossary to familiarize yourself with neurological terminology, but again the book isn't overtly prolix; rather a gripping account of neurological maladies.

Through Mr.Sack's these patients have received a certain immortality; a sense that their suffering has not been in vain, but tremendously valuable, not only to the advancement of neurology but as testament to the inherent strength and resolve in us all.

This is the true story of a group of very sick people permanently living in a hospital. They have an amazing semi-recovery due to some drug experimentation, but there is no lasting or long-term recovery.

Unlike the movie, there is no love story, and the Leonard character is not a lovable hero. But the book is well written, and the medical ramifications are clearly explained for the lay-person.

I recommend this, and all of Oliver Sacks' books, highly.

This book details the experiments with L-Dopa that Dr. Oliver Sacks put some special patients through at the Mt. Carmel Hospital in New York. These patients had been infected with encephalitis lethargica some 40 years earlier. One of the after effects of encephalitis lethargica (a disease which appeared mysteriously in 1916 and disappeared just as mysteriously in 1926) is manifestation of the symptoms of severe Parkinson's Disease. The patients had tremors, and they just seemed to freeze up, unable to move, walk, talk, or even swallow, in some cases. This left the patients in a catatonic state, and when their relatives were unable to care for them any longer at home, they were institutionalized at the hospital, together with patients suffering from dementia and other mental illnesses. Dr. Sacks, a neurologist, began working at Mt. Carmel in 1966. About that time, researchers working on Parkinson's began touting the wonders of L-Dopa, a drug that seemed to provide some relief from the Parkinsons' symptoms.

In the summer of 1969, Sacks began to administer L-Dopa to the encephalitis lethargica patients to see if it would also relieve their symptoms. The results were miraculous-at first. Patients were suddenly able to move their muscles again, and they stood up from their wheelchairs and began walking around for the first time in 20-40 years. They laughed, talked, sang and wrote about their experiences both before their illness, and during their long stay at the hospital. Unfortunately, however, the euphoria was short-lived for all, as ticks, psychoses, and other mental disorders began to set in, often after a period of a few weeks or even just a few days of relative health.

In this book, Sacks describes encephalitis lethargica, then he provides a selection of case histories, detailing patients' lives before L-Dopa, during the euphoric state of health, and the later stages, in which nearly every patient developed extreme psychological disorders that necessitated stopping the L-Dopa treatments. In the conclusion of the book, Sacks analyzes what went wrong, and generally ascribes it to the underlying mental state of the patients. He suggests that once their initial euphoria over re-joining the world wore off, weak personalities, compounded with poor relationships with family members and mistreatment over the years at the hospital came together and allowed simmering psychoses and other mental problems to bubble to the surface and drag the patients back down to their illness once again. "Love is the alpha and the omega," he states, suggesting that if these patients were more capable of loving and being loved, they could have maintained their healthy state brought on by L-Dopa.

From the vantage point of today's understanding of the brain and neurochemistry, Sacks' experiments and analyses seem inexcusable. Yes, it probably was reasonable to try L-Dopa with these patients. However, when every one of them went on to develop ticks, and psychoses, an alarm bell should have gone off. However, in the 1960s, psychosis and bipolar disorders were thought to be purely emotional problems with roots in poor relationships and attitudes. Nothing was known at the time of how brain chemistry is involved with these illnesses, so when patients starting exhibiting psychotic behaviors, Sacks blamed it on their personalities rather than questioning what else L-Dopa was doing to their minds besides easing their Parkinson's symptoms. Today, such side effects of L-Dopa are well known, and patients taking L-Dopa may also be given anti-psychotic drugs as well.

When I read the blurb on the back cover about patients waking like Rip Van Winkle from a 40-year sleep, I expected tales of a miraculous cure, tempered with feelings of loss and adjustment. But these patients weren't asleep all those years-they were just confined in bodies that would not move. For some, their minds were also slowed, but not stopped completely. They were aware of what was going on around them, but they just couldn't do anything about it. One patient could move a few fingers, and was able not only to communicate with a typing board, but even to write book reviews the entire time he was in the hospital. Thanks to L-Dopa, he had a wonderful summer of movement, but then the consequent mental side effects became so severe that he had to be restrained and taken off L-Dopa, which meant a return to his former frozen state for the remainder of his life, during which time he was so traumatized that he never wrote again. For such a patient, it's not clear that the L-Dopa experiments left him any better off than before; indeed, it appears that he felt worse off, although Sacks suggests otherwise. In sum, the book is far different from what I expected, and quite disturbing in with its tales of medical experimentation and the omnipotence of a doctor working with the severely disabled. On the other hand, it can be morbidly fascinating to see how a scientist can believe so strongly in his work based on his understanding of the world, when later research will show his basic assumptions to be very flawed, hence his conclusions baseless.

though this book can get extremely confusing at some times, it is well worth both the money, and your time. a true story, and an amazing one at that, it makes it all the more of an incredible read.

The 20th Century has ended, and we can look back on this famous classic with perhaps a better perspective. It in its own way has moved mountains of ignorance. It brought life to not only the patients in the book, but millions of neurologically impared patients in the world. It explained, along with the great movie 'Awakenings', how one could live but not really have complete life. This is a tragedy the medical profession must continue to confront with better research and treatment. Oliver Sacks originally wanted to be a researcher, but it was not in his destiny. What he became, as documented in this book, was a unique facilitator of science. He became a truly unique being that has blessed our humanity.

What is it like to be nearly frozen in time? To have your whole sense of time radically changed, so that an action that takes 3 hours in real time for an encephalitis lethargica patient is perceived by that person as taking but a moment to complete? Sacks explores this and other phenomena in a provocative, compassionate look at the people trapped inside of their own diseased bodies. Recommended reading.

Engrossing, moving, well-documented, supplemented with enlightening footnotes. Sacks documents an almost-forgotten plague and its few pitiful survivors. He explores a theme that he has returned to in subsequent books (especially in his latest, "An Anthropologist on Mars"), humanity preserved in the face of dehumanizing disease. It also presents humans helping humans live in the here and now, not just preparing for the Hereafter that may or may not await.