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on October 3, 2015
After I ordered the book, I also ordered the movie with Robert de Niro and Robin Williams, which I watched right away. The movie is way more accessible than the book, as one would assume, since it was made with entertainment, at least partly, in mind.

The book is an exhaustive look at a number of patients who had encephalitis lethargica, a flu-like disease which had a global appearance in the early 20th c., then seemed to disappeared into the ether. Patients who had it in their early lives seemed to go into a trance-like (or as Sacks sometimes called it, Parkinsonian) state and became burdens on their families. Oliver Sacks' interaction with them was typically after many years had passed, and they had been committed to the hospital where he worked. The use of L-Dopa was just beginning as a treatment for this kind of disorder, and Dr. Sacks began to experiment with it on these patients. As a result, but on a very individualistic basis, they would "awaken" from their trance, and be able to function once again as capable, intelligent and independent, even joyful, human beings. This would last for awhile, before the drug would either stop working, or have some kind of deleterious effect on the patients, all of which Dr. Sacks records in the book.

One of the fascinating aspects of the story is how Sacks describes the patients' feelings about their life experience. Some are horrified that they went to sleep at, say, age ten, and woke up much older. Others are grateful they had a chance to be alive again. Some have memory of being in the vegetative state, others don't. The way their families interact with them upon their awakening is also informative and varied; some are ecstatic, others threatened, still others downright angry.

When the book came out, the medical community shunned it, and it's easy to see why. Oliver Sacks (who died this year) was very vocal about the way he thought doctors came up short when dealing with patients, aka human beings. He railed against them for treating people separately from their disease, and treating a disease, e.g. cancer, like it was the same for every patient. His revolutionary thought was that individuals and their diseases have a symbiotic relationship, and to treat the disease, one must treat the individual. "Awakenings" is a classic example of how to do this, and an exhilarating, if also frightening, look into the human psyche.
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on December 16, 2016
Awakenings by Oliver Sacks; (5*);
This is fascinating stuff!
I am not nor was I ever a medical student nor have I ever worked in the medical field. But I am so thankful that I read this book & must say, even at the beginning of my thoughts & comments, that I highly recommend this work of Sacks. The man has a brilliant mind, very worthy of our appreciation.
I could not have read this book, had I not read ALL of the preliminary notes which take the reader well into the book and give one such as myself a very good background before going into the case studies of these special patients.
I found the book to be so much better than the movie, which I thought wonderful & which left me speechless!

The "sleepy sickness" that masks itself as Parkisonism would be difficult to garner understanding from without those previously mentioned notes. Oliver Sacks is a gifted writer. His prose is often times overly medical but again, please read the notes before beginning the case studies. The beauty of his words in regards to how medicine should be practiced and how the overly technical aspects of medicine are denying the original feeling & healing that is the true basic of the medical practice have made this book a must read for all those going into the medical field. I could go on and on but will just say: Please read this book if you have any interest in an extraordinary disease and the extraordinary processes which both the patients, other doctors, nurses & medical personnel go through long with Dr. Sacks.
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From Wikipedia regarding the "sleepy sickness":

"Encephalitis lethargica or von Economo disease is an atypical form of encephalitis. Also known as "sleepy sickness" (distinct from tsetse fly-transmitted sleeping sickness), it was first described in 1917 by the neurologist Constantin von Economo and the pathologist Jean-René Cruchet. The disease attacks the brain, leaving some victims in a statue-like condition, speechless and motionless. Between 1915 and 1926, an epidemic of encephalitis lethargica spread around the world. Nearly five million people were affected, a third of whom died in the acute stages. Many of those who survived never returned to their pre-existing "aliveness". "They would be conscious and aware - yet not fully awake; they would sit motionless and speechless all day in their chairs, totally lacking energy, impetus, initiative, motive, appetite, affect or desire; they registered what went on about them without active attention, and with profound indifference. They neither conveyed nor felt the feeling of life; they were as insubstantial as ghosts, and as passive as zombies." No recurrence of the epidemic has since been reported, though isolated cases continue to occur."
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on April 7, 2017
Awakenings is an amazing true story of the patients who suffered from encephalitis lethargica (or "sleeping sickness") outbreak after the Spanish flu outbreak in the early 1920s. These patients were left in catatonic and Parkinson's like states - sometimes for decades until Dr. Oliver Sacks, a pioneering neorologist came into the hospital and began to work with them. He revolutionized their care and treatment. Discovering that these people weren't "asleep" - but trapped inside their bodies - and aware of all the time they had missed. Dr. Sacks was able to start his patients on L.Dopa, the first patients in the country to be treated with LevaDopa now used commonly for Parkinson's and MS treatments and pioneered its use in modern medicine today. A film featuring Robin Williams and Robert DeNiro was made based on the book.

Dr. Sacks wrote several other books involving neurological conditions including; The Man Who Mistook His Wife For A Hat, An Anthropologist On Mars, Musicophilia, Migraine, and Hallucinations. I would recommended them all.
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on March 20, 2015
does one write a review after 40 years of publication of a book? yes, one doeṣ, if the book has taught you many things about parkinsonṣ. i am well read and quite knowledgeable on this heinous disease. being a care giver for the past 22 years for a patient in an advanced stage of parkinsons, it was immensely interesting to know about so many more thingṣ. the mood changes, the gait changes, changes in appetite, the changes in body flexibility, unpredictability to medicines, reaction to outside influence etc etc. this book is amazing in the presentation of so many heroic persons who fight their afflictions with so much courage and conviction and the commitment of dr sackṣ. and mostly the understanding of the attending staff and relativeṣ. no one character is more important than any other - so i am not mentioning any nameṣ. each of the sufferer has presented an unique phenomenon of struggle against a destructive disease. the appendix to the book is amazingly instructive and i simply loved iṭ. i thank dr sacks for making a difficult science like neurology so simple that even a common man could understand iṭ. when he finished the book stem cell treatment was in the inception giving a new hope of cure. later on has come the deep brain surgery. but even today we are still awaiting that miracle cure for parkinsons, just as it looked like L dopa was the miracle cure 50 years ago.
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on April 28, 2013
Carina Chiquito
Neuro 105
Professor Kreher
4/19/13
Awakenings
Encephalitis Lethargica was a sleeping sickness that had similar symptoms to those of Parkinsonism. Striking after WWI, encephalitis lethargica became a worldwide pandemic. In the United States, neurologist Olive Sacks sought to find solutions for symptoms of encephalitis lethargica. He worked with many patients who had encephalitis lethargica and distributed doses of L-DOPA, a drug commonly used to treat symptoms of Parkinson's disease. He believed L-DOPA would help reduces symptoms of encephalitis lethargica because most of the symptoms were similar to those of Parkinson's disease. Throughout the time he was distributing trials of L-DOPA, Oliver Sacks recorded many of his experiences with his patients. He would record comparisons of the patient suffering from encephalitis lethargica before taking L-DOPA and their responses after taking it. His recordings became known as one of his famous novels Awakenings.
In his novel Awakenings, Sacks describes his experiences with post encephalitic patients upon taking L-DOPA. He begins his novel with a prologue describing and making connections between Parkinsonism and encephalitis lethargica and the aftermath of those who suffered from the sleeping sickness. He then continues with how life was for patients at Mount Carmel, an institution for people who were mentally ill followed. The rest of his novel, Awakenings, is similar to a journal entry; an entry for each of the patients he worked with. He described the patients and their behaviors prior to taking L-DOPA and their behaviors after taking it.
Sacks began his Awakenings entries with Frances D, one of the various patients Sacks worked with at Mount Carmel. He begins her story by mentioning how she became a victim of encephalitis lethargic at the age of fourteen. He continued to describe her state of being as deteriorating in which she became less capable of controlling her muscles from becoming stiff for long periods of time. Sacks also mentioned how there was a point at her life when everything seemed to be normal and she was even working, but that period did not last long. Shortly after, her symptoms worsened, and she had to be institutionalized. On June 25, 1969, Frances was given a dosage of L-DOPA. Five days after being started on L-DOPA, Frances still seemed to have symptoms of tremors and excessive muscle movements. On the eleventh day of her trial, her symptoms began to reduce and her speech was a bit clearer than before.
As she continued to receive her doses of L-DOPA, Frances' symptoms began to reduce, but at the same time, she began having negative outcomes from taking the drug. Her breathing and fidgeting were becoming more and more irregular. Because her breathing seemed to worsen, Sacks was forced to discontinue the distribution of the drug, but Frances insisted on the benefits she was receiving because of the drug. Instead, Sacks reduced the dosage.
Sacks' purpose of distributing the drug was to see whether the use of L-DOPA would reduce symptoms of encephalitis lethargica. As described in his novel, patients suffering from the sleeping sickness did show some improvements with the use of the drug. The drug is meant to replace the loss of dopamine levels in the person's brain. In class we have learned that dopamine is a neurotransmitter and it helps send signals from one cell to another. Because a person suffering from encephalitis lethargica has low dopamine levels, they tend to experience tremors. With the help of L-DOPA, dopamine levels increase and the tremors are reduced. This helps explain neurotransmitter replacement therapy.
Sacks' entries of prescribing doses of L-DOPA describe relationships to what we have learned in class about pre-synaptic and post synaptic neurons as well as brain structures. Encephalitis lethargica is known to attack parts in the brain that help produce dopamine. Similar to what we learned in class, when a part in the brain is affected its function will decrease causing severe disorders. We have also learned that dopamine is an important neurotransmitter that has important role in brain function. Some of these functions include roles in a person's behavior as well as voluntary motor movement and memory. We have also learned about the relationship between the pre-synaptic neuron and the post-synaptic neuron. In a normal neuron, you will see a balance and normal production of dopamine. The pre-synaptic neuron will release dopamine to the dopamine receptors in the post-synaptic neuron. When a person suffers from encephalitis lethargica, similar to Parkinson's disease, the brain does not produce enough levels of dopamine resulting in a shortage of dopamine levels released from the pre-synaptic neuron to the post-synaptic neuron.
Overall, I really enjoyed reading this book for various reasons. In regards to Oliver Sacks, he strongly believed that prescribing L-DOPA to treat patients who suffered from encephalitis lethargica could have improved symptoms. In his entries he was able to support his beliefs, although some of the cases when prescribing this medication did not turn out as he had planned. When reading Awakenings I noticed how emotional some of the entries were. In regards to the patients, it was heartbreaking to read about the lapses they went through even after going through medication and rehabilitation. I felt as though the book showed what it really means to have motivation. In Frances' case, she insisted on receiving doses of L-DOPA regardless of the fact that it was affecting her negatively. She wanted to get better and be able to live a normal life as she used to. Unfortunately because her health was at risk, doses of L-DOPA were cut and she relapsed into a "sleep" again. When patients relapsed after taking the medication, it disproved Sacks' beliefs that there would be long term positive outcomes upon using L-DOPA.
This book was also educational in which it taught me so much about how a drug developed to treat a specific disorder has multiple purposes and can help treat another disorder. For example, we learned how L-DOPA is mainly used to treat patients who suffer from Parkinson's disease, yet it is also used to treat Encephalitis lethargica. Because most symptoms of Encephalitis lethargica were similar to those of Parkinson's, L-DOPA turned out to be a useful treatment. It would cross the blood brain barrier and convert itself into dopamine to help replace the dopamine that was lost. It also shows how the material in our class is relevant in terms of those who suffer from a p-psychological disorder as well as the relationship between pre-synaptic neurons and post-synaptic neurons.
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on March 18, 2013
Throughout Oliver Sacks' brilliant "Awakenings," he describes several almost unfathomable cases of patients who have been affected by encephalitis lethargica, the "sleeping disease." The majority of these patients were put quite literally out of commission for most of their lives, due to this epidemic that affected so many between 1916 and 1926. However, as Dr. Sacks administered to each the drug L-DOPA, all began to show incredible signs of improvement - walking, talking, and when they had been completely catatonic - for at least a little while. Unfortunately, most of them reversed their improvement, even developing Parkinson's-like symptoms worse then their pre-DOPA state.

Though this book was certainly difficult to begin, thanks to the ubiquitous medical jargon, it was more than just reporting on medical cases - it was a memoir, not simply prose but almost poetry in its flow. Sacks was able to take medical reports - often considered the routine, brunt work of doctors - and turn them into a literary masterpiece. Really, the story itself is explosive, incredible, and the stuff of dreams - the cases heightened to seemingly unreal dimensions. But it is this fantastic nature which gives this book its quality, for the stories are indeed true. Even though the treatments end badly, even fatally, for most of the patients, the story is one that should capture medical-loving minds for generations.
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on October 24, 2015
The movie of the same title based on the book made a great impression on me years ago. When I read that Oliver Sacks had died I ordered his books. It was fascinating to me to see pictures and to read about the actual people portrayed in the movie. Tragic but Dr.. Sacks was such a compassionate man who cared so deeply for his patients and tried so diligently to do the best he could for them, it was more than just case studies.Good people do good work and we have so much more to learn.
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on July 24, 2017
I just wanted to rate the book without actually giving my opinion on it. I'm much too lazy to reflect on all the amazing ideas I've read in this book, as it would take a lifetime to explain why I enjoy it so much. It'd actually be more favorable and time-efficient for you to buy and read it on your own.
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on April 17, 2013
This book is phenomenal! I couldn't help, but feel empowered and excited throughout Oliver Sack's great novel Awakenings. As I continued to read and as the plot and characters developed I felt like I was actually a part of the story. I experienced joy, when the drug L-DOPA awoke post-encephalitis patients and I felt great remorse when they returned to their "sleeping" state after the effects of L-DOPA subsided. Oliver Sack's makes his readers feel and care for his characters and live the story of those with Parkinson's disease.
In my opinion I'd say this novel is a must read. It's not the easiest read, but if you take the time to start the book you won't be able to stop!
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on February 25, 2014
The Robin Williams film of the same name was loosely based on this book by Oliver Sachs, but the film tells only part of the story, and inserts an unnecessary amount of distracting romance and sentimentalism into it.

The story of how catatonic patients, some of whom had been silent and immobile for decades, were brought back to life with the "miracle drug" L-Dopa by Dr Oliver Sachs is told as a group of case-studies. It is extraordinarily fascinating, touching and thought-provoking.

This is a book which will haunt you and inspire you. Highly recommended.
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