Jun 18, 2010

Awakenings

by Oliver Sacks

This book was tough to read, but also very interesting and moving. I had heard of the title before, and knew there was a film, but was unaware of the premise. So for those of you who haven't heard about it, I'll outline what I can. Awakenings is based on true events. Post-WWI there was a widespread epidemic of encephalitis, or sleeping-sickness. It is a viral infection that affects the brain. Thousands of people ended up with stiff limbs, constricted movement and/or tremors, or so catatonic that those who hadn't known them before their illness thought they were severely mentally disabled. There was no known treatment and most of them were put in asylums or chronic care hospitals, where they remained nearly motionless for decades (one very sad story tells of a man who got encephalitis when he was only three years old. He was ill for his entire life- over fifty years). In the 1960's a new drug was discovered, L-DOPA, which was used to treat patients with Parkinson's disease by supplying more dopamine to the brain. Oliver Sacks was one of the first to try it on post-encephalitic patients, with astonishing results. People who had not moved a muscle voluntarily for twenty years or more suddenly got up and walked, people who had been mute during their entire illness could speak again. Even more astonishing though, was the wide range of reactions to the drug. It affected every patient differently, and to a different degree. Some responded well, others hardly at all. A lot of them experienced other effects- their movements would become extremely hurried or uncontrolled, they would have violent thoughts and hallucinations, they would be completely unable to sleep- a few even died of exhaustion after weeks of sleeplessness or incessant movement. When taken off the drug, they often regressed to being even more catatonic than before, and when given it again as a second trial, they had an entirely different reaction than the first time!

It's all very complicated. I didn't really understand what this drug was doing to the brain, but it obviously had some positive results- many patients begged to be given it again even after experiencing terrifying "side-effects" because they preferred even crazed, uncontrollable movements to feeling "encased in stone". The book is amazing in describing what these patients went through. There is an introduction about the sleeping-sickness epidemic, condition of the patients and the hospitals they lived in. Then brief case studies are included, describing what each of some twenty patients experienced before, during and after treatment with L-DOPA. The edition I have is quite extensive and has several forwards written for different re-issues, a section analyzing in more depth the response of patients to treatment, and an epilogue written ten years after the first publication, describing further developments and what happened to all the patients since the first publication. There's also a very interesting chapter at the end describing the making of the 1990 movie version. Robin Williams and Robert DeNiro visited the hospital where Sacks worked, to meet the surviving patients and learn how to be like them. Sacks made it very clear that while the film director may have added some extra storyline that didn't happen in real life, the actors' portrayal of how the patients moved and spoke was very accurate. We watched the film immediately after I finished reading the book, and it was very moving.

I feel like I'm only scratching the surface here, of what this book contains. I also struggled with reading it. It could get very technical and even philosophical-sounding very quickly, and I didn't discover until I was nearly done that there was a glossary of medical terms in the back, tucked between two other appendices. So for most of the time I was reading I would guess at a meaning in context, or skim a paragraph or two when it got too complicated and I started feeling lost. I would have rated this book a "4" in my little system, if it had been easier to understand. It's not quite as "reader-friendly" as his other books I've read.

Rating: 3/5 ........ 408 pages, 1973

More opinions? When I searched for other book reviews I only came up with posts about the film. If you've posted on this book, please let me know and I'll add your link!

3 comments:

Sandy Nawrot said...

These books are great for in-depth information on a subject, but can be hard to get through because they are dense! I have seen the movie, and it was just an amazing movie, and also heartbreaking. I think that might be enough to inspire me to read the book (I had no idea there was a book!).

Jenny said...

Oh wow. I knew about the sleeping sickness, vaguely - Neil Gaiman incorporated it into the early issues of his Sandman - but I'd never heard of this drug before. This sounds interesting!

Jeane said...

Sandy- The book is really very informative, but for just getting a grasp on what was going on I think I preferred the movie (even though of course it left out a lot of things).

Jenny- I bet you'd like this one.