Read Risvegli by Oliver Sacks Andrea Salmaggi Online

risvegli

Per dieci anni, fra il 1917 e il 1927, una grave epidemia di encefalite letargica (malattia del sonno) invase il mondo. Quasi cinque milioni di persone furono colpite dal male. Poi l’epidemia scomparve, improvvisamente e misteriosamente come era sopraggiunta. Una minuscola frazione dei malati sopravvisse, in una sorta di perpetuo torpore, fino al 1969, quando un nuovo farmPer dieci anni, fra il 1917 e il 1927, una grave epidemia di encefalite letargica (malattia del sonno) invase il mondo. Quasi cinque milioni di persone furono colpite dal male. Poi l’epidemia scomparve, improvvisamente e misteriosamente come era sopraggiunta. Una minuscola frazione dei malati sopravvisse, in una sorta di perpetuo torpore, fino al 1969, quando un nuovo farmaco, la L-dopa, permise di risvegliarli. Oliver Sacks, fra il 1969 e il 1972, somministrò questo farmaco a più di duecento malati al Mount Carmel Hospital di New York. Risvegli racconta le storie di venti di loro. Già da tali elementi è facile rendersi conto della impressionante singolarità di questo libro. Ma qui, ancora una volta, l’elemento decisivo è il narratore: Oliver Sacks, colui che sa farsi strada all’interno delle esperienze più remote e inaccessibili dei suoi pazienti. Ciascuna delle persone di cui Sacks qui racconta è un mondo a parte, ma tutte sono unite da una caratteristica: quella di aver passato la maggior parte della loro vita in una zona inesplorata e muta, vicino «al cuore oscuro dell’essere», e di essere stati sbalzati dalla «notte encefalitica» verso le «tribolazioni» e le meraviglie del risveglio. Sconvolgente è la varietà e la qualità delle esperienze che queste persone tentano disperatamente di comunicarci. E stupefacente è la capacità che qui Sacks dimostra nel capire e ricostruire il tessuto drammatico di tali esperienze. Confidando, come il grande Lurija, in una visione della medicina come «scienza romantica», Sacks rivendica la definizione della malattia che leggiamo in Novalis: «Ogni malattia è un problema musicale. Ogni cura è una soluzione musicale». Appunto questo presupposto gli ha permesso di accedere ai mondi murati di persone che vivevano nell’oscillazione fra una terribile presenza e una terribile assenza. E questo contatto si è rivelato essere il più grande aiuto che possiamo dare a chi cerca, con pena infinita, di trovare un accomodamento con la realtà. Dietro le cartelle cliniche, qui si apre uno sconfinato paesaggio, «un paesaggio molto variato, in parte familiare, in parte inquietante, con altopiani battuti dal sole, abissi senza fondo, vulcani, geyser, praterie, paludi; qualcosa come il parco di Yellowstone: arcaico, preumano, quasi preistorico, con una sensazione di potenti forze sobbollenti tutt’intorno». Risvegli apparve nel 1973 e da allora l’Autore lo ha più volte rielaborato nelle successive edizioni....

Title : Risvegli
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ISBN : 9788845908026
Format Type : Paperback
Number of Pages : 560 Pages
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Risvegli Reviews

  • William1
    2018-12-16 23:00

    The crux of the book is the work Sacks began in the mid-1960s with dozens of post-encephalitic patients at Bronx's Beth Abraham hospital, then called the Bronx Home for Incurables and disguised here as Mount Carmel. These patients were infected in 1918 by the encephalitis lethargica virus, or sleepy sickness. (Not to be confused with the worldwide influenza pandemic of that same year.) Those who survived were able afterwards to lead normal lives for years and sometimes decades until they were stricken with Parkinson's disease-like symptoms: locked and rigid postures that turned them into living statuary (akinesia), hurrying gait (festination), frozen skewed gaze (oculogyyric crises), and so on. These patients did not have Parkinson's disease proper, but because the encephalitis reduced the neurotransmitter dopamine in the part of their brain known as the substantia nigra they experienced identical, if somewhat more severe symptoms than actual Parkinson's patients. They were to become know as post-encephalitics.In 1969 L-DOPA's cost came down sufficiently that Dr. Sacks began to prescribe it for his post-encephalitic patients. The results were at once miraculous and disastrous. In a matter of weeks, sometimes overnight, Sacks's patients were "awakened" from what for many had been decades of immobility, incommunicability, and dependence on high levels of nursing care. Suddenly these frozen figures were walking and talking, their personalities, in hiatus for so long, perfectly preserved. Dr. Sacks reviews the cases here of 20 such patients, from their often sudden awakening to the onset and growing severity of side effects. Awakenings is in the final analysis a tragedy. Few of Sacks patients could tolerate the long term effects of L-DOPA. Not a few regretted ever being treated with it. For a handful it provided a vastly improved quality of life. They became social again, needed far less nursing care, but the effects of the drug were highly unstable. In an appendix added to the 1990 edition, Sacks and a colleague analyze patient responses to L-DOPA using the then emerging discipline of chaos theory. This appears only in the 1990 edition since the discipline did not exist when Sacks and his patients began their trials of the levodopa in '69. Dr. Sacks never met a footnote he didn't love. The book is chockful of them. Those too long to fit alongside the text are included as appendices. Ninety-five percent of them seem to me indispensable. Sacks is a great thinker of immense erudition who possesses a highly readable prose style. The primary text provides straightforward exposition, but when read in conjunction with the footnotes--where much of the real meat of the book resides--it can at times take on an almost fiction-like discursiveness.Of Sacks's dozen or so books, I've read all but three. Awakenings is his magnum opus, his manifesto and policy declaration. In it he lays out his positions on the then current neurology of the day (Awakenings was first published in 1973) which he lambastes as coldly empirical and lacking a complementary metaphysical component. In America, and no doubt much of the West, these were the last years of the Physician as God. There was little public knowledge of medicine then, unlike today, and the doctor's role in a crisis was usually unquestioned. Today second opinions are sought with regularity, "integrative" approaches to healing more readily embraced, and there is a vast industry based on purveying medical knowledge to the general public. You can see this great change perhaps best in the way pharmaceutical companies now advertise directly to the public in a way they never did during the Awakenings period. Sacks is here an articulate proponent for a more human, less coldly analytical medicine, and his endorsement for such an approach, which includes close interpersonal relationships with patients, is a clarion call. Fascinating, meticulous, and highly recommended.One appendix is devoted to the many dramatizations of Awakenings on stage and screen. There's Harold Pinter's one-act play A Kind of Alaska, an original documentary film, and the feature film, which retained Sacks as a consultant. I found his descriptions here of DeNiro preparing for his role as Leonard L. fascinating.

  • Malacorda
    2018-12-21 20:52

    Della "scienza romantica" Più che quattro, sarebbero tre stelle e mezza. Come sempre, in caso di non-fiction, è doveroso precisare: il giudizio si riferisce alla godibilità, alla fruibilità dell'opera letteraria, e non certo alla persona dell'autore, o ancor meno all'esperienza e ai concetti che lui intende trasmettere, perché allora le stelle da assegnare sarebbero ben più di cinque. Questo è il libro da cui è stato tratto il celebre film con Robin Williams e Robert De Niro. Come sempre, nel libro c'è molto più che nel film, è un'opera complessa che esula da qualsiasi genere. Lo stesso autore sottolinea più volte, nelle prefazioni, come il suo lavoro si trovi "al punto di incrocio fra Biologia e Biografia". "Attraverso di loro (i pazienti) io indagavo ciò che significa essere umani, e rimanere umani, di fronte ad avversità e minacce inimmaginabili. Quindi, pur continuando a controllare la loro natura organica - le loro fisiopatologie e biologie complesse e sempre mutevoli - , l'oggetto e il motivo centrale dei miei studi divennero le loro identità e la loro lotta per mantenere un'identità: osservare questa lotta, aiutarla e infine descriverla." In verità, quella che doveva essere forse la premessa fondamentale, viene data un po' per scontata: il fatto di iniziare a curare le sindromi postencefalitiche con il farmaco denominato L-dopa ha evidentemente tutta una storia alle spalle, una storia che qui viene però sbrigata in poche pagine per passare direttamente all'analisi degli effetti concreti del farmaco sui singoli pazienti. Del resto, è lo stesso Sacks a confidare nelle premesse che il libro sarebbe stato scritto ugualmente anche se non ci fosse stato nessun risveglio in nessun paziente: dice che lo avrebbe intitolato "Il popolo dell'abisso" o "Cinquante ans de sommeil" per fare il resoconto dell'immobilità e del buio di tutte quelle vite fermate e congelate. Più volte egli si meraviglia di come essi abbiano potuto sopravvivere a un tale martirio, attingendo a riserve di forza dalla profondità sconosciuta e insondabile, e riflettendo in generale sul fatto che la salute ha radici più profonde della malattia. Lettura non scorrevole e non facile, sia per la quantità di note e riferimenti che bisogna sempre andare a ritrovare nell'appendice, sia perché le descrizioni dei casi clinici sono veramente dettagliate, e la quantità di termini tecnici arriva a tratti a formare delle vere e proprie raffiche. Ma la pacatezza del tono e la bontà della scrittura e la profonda umanità di questo medico che come prima cosa si propone di ascoltare il suo paziente e considerarlo come un essere umano anziché come un oggetto, tutto questo non viene mai meno, neanche per un secondo. Egli pone sempre l'accento sulla dignità del paziente, la sua allegria o malinconia, le sue aspettative, ascolta i loro racconti e riporta i loro diari, pone attenzione anche all'atmosfera spesso cupa e chiusa del cronicario e agli sforzi (suoi e di buona parte del personale) per cercare di renderla più familiare e solidale. Ed è così che, passando un po' sopra i tecnicismi più complessi, ci si addentra con semplicità in queste storie fatte di sofferenza e solitudine: una serie di storie, di venti pazienti, esposte una ad una e che costituiscono il cuore di quest'opera. E la parte specialissima di questo cuore, è senza dubbio la storia del paziente Leonard, che non a caso è divenuto il protagonista del film: "Questa combinazione di un gravissimo stato di malattia e di un'acutissima intelligenza analitica faceva del signor L. un paziente per così dire "ideale": nei sei anni e mezzo dacché lo conosco mi ha insegnato più cose lui sul parkinsonismo, sulla malattia postencefalitica, sulla sofferenza e sulla natura umana che non tutto il resto dei miei pazienti messi insieme." Ma nelle corpose prefazioni e postfazioni non mancano le riflessioni sul morbo di Parkinson più in generale, la psicologia, la neurologia e la neurochimica, e ancora più in grande sulla medicina tutta e sulla farmacologia, e poi ancor più in grande, con ricchezza di citazioni e riferimenti che denotano la persona colta, fino a suggerire analisi di tipo relativistico e quantico, filosofico e metafisico: "...e questo è così vero che mi meraviglia che la relatività e la teoria dei quanti non siano state scoperte dai biologi molto prima che dai fisici." "Tutti questi stati di anacronismo, così come altre stranezze temporali descritte in questo libro, indicano quanto sia profondo l'abisso fra l'astratto e il reale, il cronologico e l'ontologico, nel nostro modo di concepire e percepire il tempo." "In quell'attimo mi fu subito chiaro che il parkinsonismo non può essere considerato come qualcosa che aumenta o diminuisce per quantità finite. Di colpo compresi che il parkinsonismo era una propensione, una tendenza, che non aveva un minimo o un massimo, né unità finite; che esso era anumerico; che dal primo, infinitesimale accenno esso poteva procedere, attraverso una infinita moltitudine di incrementi infinitesimali, fino a raggiungere una gravità infinita, e poi più infinita, e poi ancora più infinita. […] Così, il più piccolo accenno di parkinsonismo (o di emicrania, o di angoscia, o di estasi) prefigura il tutto, ha già, in miniatura, la qualità del tutto, è il punto di partenza di un'espansione potenzialmente infinta." "Si può soltanto dire che in larga maggioranza i sopravvissuti scesero irrevocabilmente, cerchio dopo cerchio, nel baratro di una malattia sempre più profonda, senza speranza, vittime di una solitudine inimmaginabile, e di tutto, proprio la solitudine era forse la cosa più insopportabile. "Come la malattia è la peggiore afflizione, così la peggiore afflizione della malattia è la solitudine... La solitudine è un tormento non comminato neppure nell'inferno" (J. Donne)." Oltre alla meraviglia nello scoprire le storie dei suoi pazienti, e all'interesse nel leggere le riflessioni di Sacks stesso – un uomo che ammette, per sua storia, di essere mezzo medico e mezzo artista e di avere unito le due cose nella sua esperienza personale – resta il rammarico nel rendersi conto che, per la maggioranza dei medici, l'esercizio della medicina resta niente altro che quella faccenda meramente meccanicistica così ben spiegata e deplorata dall'autore di queste pagine. Il gran pregio di questo libro è proprio di insegnare ad analizzare i problemi guardandone le due facce: da un lato quella meccanica, che si può sterilizzare e isolare dal resto del mondo; e dall'altro lato quella che non si può misurare in numeri o indici ma solo in sensazioni e sentimenti. Nell'analisi di entrambe, Sacks sa sempre mantenersi estremamente concreto e rigorosamente scientifico. "Tutto il mio libro si occupa di queste domande ("come stai?", "come va?")[…] Il dialogo su come uno sta può essere espresso solo in termini umani, in termini familiari, che vengono facilmente e naturalmente a tutti noi; e può svolgersi solo se vi è un confronto umano diretto, una relazione "io-tu", fra il mondo di discorso dei medici e quello dei malati." "Salute, malattie e reazioni non possono essere capite in vitro da sole; possono essere capite solo se riferite a noi, quali espressioni della nostra natura, del nostro vivere, del nostro esser-ci. E tuttavia la medicina moderna, in misura sempre maggiore, prescinde dalla nostra esistenza, o col ridurci a repliche identiche che reagiscono a "stimoli" prefissati in modi altrettanto prefissati, o col considerare le nostre malattie semplicemente come fenomeni estranei e cattivi, senza relazione organica con la persona malata. Il corrispondente terapeutico di idee del genere, naturalmente, è l'idea che si debba aggredire la malattia con tutte le armi di cui si dispone, e che si possa sferrare l'attacco del tutto impunemente, senza un solo pensiero per la persona che è malata. Tali concezioni, che dominano sempre più l'intero panorama medico, sono tanto mistiche e manichee quanto sono meccaniche e inumane, e sono tanto più perniciose in quanto non sono realmente capite ed esplicitamente dichiarate e confessate." "...bisogna smettere di considerare tutti i pazienti come copie conformi, e onorare ciascuno di loro con un'attenzione individuale, attenzione a come sta lui, singolarmente, alle sue personali reazioni e propensioni; in questo modo, avendo il paziente come proprio uguale, compagno di esplorazione e non marionetta, si possono trovare vie terapeutiche che sono migliori di altre, tattiche che si possono modificare secondo le esigenze della situazione. Dato uno "spazio di azione politica" non più semplice o convergente, l'intuito è l'unica guida sicura: e in questo il paziente può benissimo superare il suo medico." "Senza loro desiderio né colpa, questi pazienti si trovano a esplorare gli abissi e le possibilità estreme dell'essere e della sofferenza umani. Le loro non cercate crocifissioni non sono senza frutto, se consentono di aiutare o illuminare altri, se ci portano a una maggior comprensione della natura dell'afflizione, dell'attenzione amorevole e della cura strettamente medica. […] Ciò che vediamo è, in definitiva, l'assoluta insufficienza della medicina meccanicistica, la totale inadeguatezza di una visione meccanicistica del mondo. Questi malati sono smentite viventi al pensiero meccanicistico, così come sono esempi viventi di un pensiero biologico. […] Ci ricordano che siamo sovrasviluppati in fatto di competenza meccanica, ma manchiamo di intelligenza, intuizione, consapevolezza biologiche; ed è questo, soprattutto, che dobbiamo riguadagnare, non solamente la medicina, ma nella scienza in generale." "...e la particolare gioia che ho provato lavorando con i miei postencefalitici negli ultimi quindici anni è stata la fusione degli approfondimenti scientifici con quelli "romantici", la scoperta che la mia mente e il mio cuore erano parimenti esercitati e coinvolti, il sapere che qualsiasi altra cosa sarebbe stata un abbandono di entrambi."

  • Megan
    2018-12-30 20:44

    Reading this makes me wish all doctors approached medical practice the way Dr. Sacks does. His clinical grasp of neurology is impressive, but his humanity, compassion, and philosophical approach lend him a more effective manner than other clinicians. His ability to present the conditions of his patients and their treatment as more than either/or, as more than a list of data points, is what makes this book a classic. A basic familiarity with neurology makes this an easier read; he uses a lot of medical terms to describe symptoms and treatments. However, he goes beyond symptoms to see how the patients in his care interact with their disease, treatment, and environment as unique individuals. Science in general and medicine in particular have been on a decades-long reductionist trend - as though all conditions can be boiled down to the one gene, the one protein, the one chemical that will take care of it all. In reality, life is too complex for that to work most of the time. Dr. Sack's ability to approach patients as whole, unique beings full of life is the key to his popularity as a physician and writer.

  • Zanna
    2019-01-08 19:00

    The story is thrilling: the sleepy sickness epidemic that followed WWI left many people with profound Parkinsonian symptoms; some were hardly able to move, never spoke, seemed frozen in time for forty years. A large number of these patients were under Sacks' care at Mount Carmel hopital in New York in 1969 when he decided to try giving them the new drug L-DOPA, and witnessed many of them coming suddenly, vividly to life. But this blurb summary is a gross simplification! Sacks is at pains even in the introductions to point out that L-DOPA is extremely unpredictable, producing different effects even in the same patient, and always leads to some 'tribulations'. Also, the case studies that form the dramatic heart of the book were less fascinating to me than Sacks' writing around them. In a way, the case studies are richly personal: Sacks insists again and again on treating patients as people, that 'nothing can be reduced to anything' and that 'if we do not listen to our patients we will never learn anything'. However, the clinical detail is extensive and given in terminology that takes time to get used to. When Sacks reflects on their implications, in contrast, he writes in expansive, lucid prose, linking the mysteries of Parkinsonism to quantum mechanics and to lyrical, existential poetry.This is a wonderful book for writers, because, as often in Sacks' work, it goes to the heart of what forms character, identity, personality. When he asserts that 'style is the deepest thing in one's being', I am struck by the resonance with some of the most thought-provoking philosophy and criticism I have read. The succinct expression here is powerful, and it is fleshed out by meditations on the notion of health as musicality and free flow, of being as moving, which the 'phantasmagoria' of Parkinsonism most graphically disrupts and distorts.A section on stage and screen interpretations of the original work is included. Sacks, initially concerned that any adaptation would be 'unreal' was delighted by Pinter's response A Kind of Alaska: "I felt Pinter had given me as much as I gave him: I had given him a reality - and he had given me one back."Ultimately, Sacks eloquently calls for an existential medicine. Over and over he emphasises how deeply affected patients are by their effective imprisonment in a 'Total Institution' and describes how they respond to music, visitors, trips out, as well as to the physical and care environment, in extraordinary and radical ways. Awakenings allows us to glimpse deep truths about health and disease, and their integrity with personhood, that should transform the ways we think about them.

  • Ashley
    2018-12-27 14:47

    Eh, this book was somewhat of a let down I thought. There is a marvelous story here, but this book couldn't decide if it wanted to be a clinical write up of these patients, or appeal to the masses. It tried to walk the line between the two and failed. Just as I would get into the story about a patient, a bunch of medical terms about their condition would pop up, I'd have NO clue what they meant, and the enchantment would end. Three stars for the effort, and because the substance is pretty amazing.

  • Francesco Scarlata
    2018-12-17 17:56

    Si tratta di un libro estremamente complesso e affascinante. Il dottor Oliver Sacks fa un resoconto dettagliato della sua esperienza con un gruppo di pazienti malati di parkinsonismo post encefalitico. Negli anni '20 una malattia misteriosa e tremendamente invalidante - l'encefalite letargica - colpì parecchie persone a livello epidemico; sebbene all'apparenza i sopravvissuti risultassero guariti, dopo un certo periodo cadevano in uno stato di trance che li portava ad una totale immobilità. Venne rilevato che la sindrome presentava aspetti simili al morbo di Parkinson e pertanto si tentò una cura sperimentale con un farmaco usato appunto per il Parkinson: la L-Dopa, usata per stabilizzare i livelli di dopamina nel cervello dei pazienti affetti dal morbo.I risultati furono interessanti e in un certo senso miracolosi: molte persone trasformate in statue dall'encefalite si risvegliarono, tentando di riappropriarsi del tempo e della vita che la malattia aveva loro sottratto.Il libro è diviso in due parti: la prima è "clinica", è una serie di rapporti su sintomi, attese, cause ed effetti; la seconda è "umana", e qui Sacks si mostra un medico diverso dalla comune accezione a cui probabilmente siamo abituati. Sacks avverte la deficienza di un linguaggio - quello scientifico - che tende a sottrarre importanza alla singola persona a favore della casistica puramente matematica. I pazienti sono chiamati così perché hanno pazienza, perché sono esseri umani, e la loro condizione merita di essere analizzata soprattutto alla luce di questa consapevolezza. E qui diventano interessanti le considerazioni sulla natura umana della sindrome post encefalitica: è messo in questione il rapporto della persona con la realtà che la circonda, il senso di impotenza nei confronti di un mondo col quale i "dormienti" risvegliati tentano di avere nuovamente a che fare. Mi hanno colpito molto le parole riportate da Sacks di alcuni pazienti, che, oltre al blocco del proprio corpo, avvertivano la sensazione di sentirsi ingabbiati perfino nel pensiero. Il non pensare a niente, il non sentire alcun accadimento attorno a sé, la presenza del vuoto, la totale assenza di coinvolgimento emotivo oltre che fisico sono le questioni su cui Sacks insiste parecchio perché sono in ultimo quelle che ci riguardano non solo come casi clinici ma soprattutto ci coinvolgono come persone. "Risvegli" è una lettura drammatica, difficile, ma anche educativa. E' un libro che ci insegna a guardare le cose da una prospettiva diversa. Ve lo consiglio!

  • Joanne Annabannabobanna
    2019-01-03 15:51

    Simply astonishing. My first experience with Oliver Sachs, long before any movie. Stumbled across it while browsing a tiny one room library located in the charming community of Vankleek Hill, Ontario where I lived at the time, and immediately became absorbed by the history of the so-called Spanish flu, its effects and the incredible results produced by Sachs' medical intervention. Not least affecting was the eloquence with which Sachs wrote about the patients in his care, which provoked intense feelings of empathy and compassion for the patients. Everyone should read this to experience the same profound awakening I have, I thought. Then came the movie. As much as I respect Penny Marshall's directing abilities and enjoy some of Robin Williams' work, the movie has to be one of the biggest disappointments of all time, in my book.

  • Nourhan Elkafrawy
    2019-01-11 18:48

    one of the most wonderful books I have ever read in my life ❤😍 and the movie for Robin Williams and Robert de Niro is a magnificent piece of art 👏😍

  • Kati
    2018-12-25 23:02

    I’m going to try to limit my rating to the quality of the book itself and not the events it portrays. I’m afraid under that criteria I can’t rate Awakenings any better than a ‘2’ for the majority of it, although the portions added in 1982 and 1990 are better written than the original material from 1972. This book has an unfortunate quality of being neither here nor there. Much of the book is filled with highly technical terms and seems that it was not really written with the layman in mind, and yet often Sacks starts waxing philosophical in a way not suitable for a strictly medical case study. He also does a poor job of expressing why he continued trying L-DOPA on new patients despite the large number of often spectacular, sometimes perhaps fatal, failures in this population — failures that happened quite quickly. (Most ‘Awakenings’ lasted only a few days to a few weeks in the luckiest cases and then started to collapse into intolerable agitative symptoms.) His descriptions to me read as though most of the patients ended up worse off after L-DOPA than they were before, a rather impressive feat given how badly off they were to start. The 1982 epilogue suggests there were therapeutic benefits that weren't well described compared to the negative effects, and patients who did better but were not spectacular enough to include in the 20 presented case studies, but some of the included cases still seem grossly irresponsible to me as a reader. The writing also seems as though Sacks at this time fundamentally lacked an of understanding of how other people worked. This is not as strange as it seems at first glance, since Sacks is not a psychologist. He’s a neurologist who has struggled with near-paralyzing shyness. In the additions written in 1982 and 1990 he seems to have outgrown some of that psychological ignorance, but unfortunately the 1972 portion where it is present is the meat of the book. I would also be remiss if I did not mention that the book contains 173 footnotes, many of them essay length. In my opinion, this is just bad writing technique. The material should have either been incorporated into the body of the work, or omitted entirely.

  • Ghada
    2019-01-15 16:02

    L-DOPA…. Sometimes Hell-DOPA!!دواء ثوري زي اكتشاف البنسيلين كدابيساعد في رفع مستوى الدوبامين في المخ وبيسخدم بشكل رئيسي في علاج مرض باركنسونالكتاب مش قصة الفيلم الجميل اللي بنفس الإسم http://www.youtube.com/watch?v=JAz-pr...لكنه مستوحى من الحالات اللي قصصهم في الكتاب ده , وبطل الفيلم "ليونارد" هو أكتر حاله أثرت في دكتور أوليفر وأتعلم منه كتيرالكتاب مقسوم جزئين تقريباً: أول جزء قصص لعدد من الحالات الأربعين اللي كان مسؤول عنهم دكتور أوليفر من سنة 1966 ...مش مجرد شرح للحالات وتأثير الدواء الجديد عليهم ,لكن القارئ/المستمع يقدر يحس نفسه عايش معاهم وحاسس بيهمبمجرد ما بدأت أسمع قصة "ليونارد إل" ظهر في دماغي الفيلم على طول وآداء روبيرت دي نيرو :)الجزء الثاني: تحليل طبي ونفسي (رائع جداً) وإنساني لرحلة سنين مع الـ إل-دوباوفي نهاية الكتاب بيتكلم عن تصوير الفيلم المعروف و أفلام تانيه كمان مستوحاه من الكتابأكتر حاجه حبيتها في الكتاب الجزء اللي بيتكلم فيه عن مشاعره هوَ (دكتور أوليفر) وهو بيجرب الدواء الجديد على مرضاهأوقات كتير بسأل نفسي هي الدكاتره وهمَ بيجربوا دواء جديد (علاج مش معروف تأثيره وممكن يدمر إنسان) أو عمليه جديده على البشر بيحسوا بإيه؟؟ للي حابب يتعرف أكتر على مرضEncephalitis lethargica أو إلتهاب الدماغ النوامي http://en.wikipedia.org/wiki/Encephal...http://www.youtube.com/watch?v=QNum0d...و فيديو (مخيف شويه) للحاله http://www.youtube.com/watch?v=5lNVtU...وللدكاتره القناة دي على اليوتيوب عليها فيديوهات طبيه تاريخيهhttp://www.youtube.com/user/WellcomeFilm

  • Tittirossa
    2018-12-20 17:49

    Non potevo non leggerlo dopo aver visto il film (ho un meccanismo interno avverso e contrario: se ho letto il libro non posso vedere il film, se vedo il film devo leggere anche il libro). L'ho letto come un romanzo d'avventura, l'ho studiato come un libro di testo. Un'odissea dolorosa e infinitamente umana, quella del dottor S. e dei suoi pazienti. Che tutto capivano, ma non potevano vivere. E quando sono tornati alla vita sono stati sopraffatti da una fisicità sfuggita al controllo del cervello. La sofferenza di qui tic, delle posture, della scialorrea, dell'acinesia, del congelamento, degli orrori e delle visioni notturne, S. te la vivere sulla pelle e nel cervello. Senza cadere in pietismi, senza calcare la mano, senza affondare nella retorica. Con stile profondamente partecipe ma non disperato. Con una umanità incredibile. Non riesco a pensare a Rose, Frances, Lilian, Leonard ea tutti gli altri se non con sgomento. Per una vita vissuta dietro le sbarre, senza la "consolazione" di stare pagando per un crimine. Senza la speranza di rinascere. E poi, il miracolo. Che si porta dietro un carico di sofferenza forse ancora maggiore. Togliendo in pochi attimi quello che con tanta generosità aveva dato. Ma è l'abisso, gli abissi mentali in cui sono precipitati gli encefalitici la cosa più angosciante. Svegliarsi e sapere che – come una bomba ad orologeria – si tornerà a vivere come prima, a non-vivere.

  • Peejay Who Once Was Minsma
    2018-12-25 21:03

    This is a true story about people who became prisoners of their own brains, their own brain chemistry. Just after World War I an epidemic of sleeping sickness froze these patients in a trance-like state. Long thought to be untreatable, they were suddenly brought back to life in 1969 when Dr. Oliver Sacks gave them the drug L-DOPA. They woke to a world that had changed utterly in the intervening years. Some of them were able to adjust, some could not deal with the changes in the world and in themselves and lapsed back into their frozen state.But this isn't just a sad story. There's also something numinous about this book. It's far more profound and amazing than the movie that it's based upon it. That was a good movie, but the Robert DeNiro character--as is a necessity when condensing a book for film--is really a composite of many people. What makes the book so much deeper and richer are the many stories of the patients Oliver Sacks deals with, how their spirits soared, or didn't, what it means to be a human being. Their struggles to come out of the horrific consequences of their disease into a new life are a testament to the human spirit, both positive and negative. Sacks' writing is as profound as the story he tells.

  • MrsJennyReads
    2018-12-28 21:50

    My husband bought this book and he has great taste in books. I decided to read this for the challenge. I’ve noticed there are a lot of books out now about disease. Its like the new fad. I have a condition called papilledma. Its not deadly, which I am blessed by GOD for that. I don’t like reading about people suffering because I know how it feels. I have watched enough people be sick and I don’t want to read about it. That’s my personal choice. But this book was very insightful.I am very blessed to have a husband that God blessed me with to support me. I love you JacobMy Review:Awakenings is a very moving tale. It is Sacks’s opus about the encephalitis lethargica virus. Very dramatic and full of heart, we suffer with Sacks as he suffers with his patients as they experience an awakening from their catatonic trances after he gives them L-DOPA. We then watch the journey for those who can adjust and those who cannot. A very touching book of not just medicine and science, but of hope and compassion.

  • Ian
    2019-01-15 22:48

    I am struggling to find words to describe my feelings of amazement at the case histories set out in this book, and my wonderment at what a strange place the mind can be. For anyone unaware of the background, in the sixties Dr. Sacks worked with survivors of an epidemic of encephalitis lethargica that began in Central Europe in 1916 and lasted for about 10 years, affecting an estimated 5 million people worldwide. In the severest cases, such as Dr. Sacks’ patients, survivors were left in a near catatonic state, behaving with near total apathy and indifference to the world around them. By the 1960s it had been established that the victims of post-encephalitic conditions were lacking the neurotransmitter dopamine, and the drug L-Dopa was developed in an attempt to compensate. Initially the results were startling, with patients who had been profoundly ill for decades suddenly “awakening”, sometimes within hours of receiving L-Dopa. Unfortunately, within a few weeks a large majority of the patients began to manifest new illnesses, the variety and complexity of which are too great for this review. Overall, L-Dopa’s effect on patients ranged from the beneficial to the catastrophic. The story is told through 20 individual case histories presented by the author, followed by a variety of reflections, postscripts and appendices, where Dr Sacks makes the case against a “mechanistic” approach to medicine, and the tendency to treat patients as replicas of each other (the book was written in 1972, so this argument was probably more radical then than it sounds now). Dr. Sacks is eloquent in drawing conclusions, but at times I found his detailed arguments quite dense, and his writing style a bit too florid for my taste. It’s for this reason that I haven’t given the book a 5-star rating. It deserves that in every other aspect.In 1990 the book was made into a film starring Robin Williams and Robert De Niro. The last of the appendices provides a fascinating account of the making of the film. I haven’t seen it, but will look out for it now.

  • Jean Cole
    2018-12-27 18:00

    After the flu epidemic of the 1920s there was another epidemic which I was not aware of. It was called "sleeping sickness", technical term "encephalitis lethargica". Literally millions of people fell to this disease, whose main symptoms are absolute loss of motion and speech. This condition is related in some way to Parkinson's Disease. A good number of these people were hospitalized in Mount Carmel hospital in New York for decades with no change in their condition. Then in the 1960s Dr. Oliver Sacks began treating these patients with a drug known as L-DOPA.This book contains information about the disease itself and case histories collected by Dr. Sacks. Sadly, the typical arc for these poor people was abrupt return to motion and speech, followed by such extreme levels of action that the doctors were compelled to withdraw the L-DOPA. There were just a handful of patients who were able to resume a "normal" life among the hundreds treated by Dr. Sacks.This is a highly technical book and the case histories became somewhat repetitive for me, so I was glad I decided to read the after-matter, including a section called Perspectives. Here Dr. Sacks stresses the tendency of the medical community to treat the disease, not the person. His point being that even after having been literally immobile for decades, these patients were, for the most part, filled with joy and gratitude for even the briefest return to participating in their world. He laments the concentration on treating the symptoms versus the treatment of the human being who is suffering these symptoms.Those with an interest in medicine or the treatment of Parkinson's disease will find this interesting, but it's not an easy read by any means.

  • Lyn Elliott
    2018-12-18 17:52

    This was the first of Sacks's books I read, and I had never read anything like it. The discovery that a chemical could bring 'frozen' people to consciousness again after an apparent sleep of years, was mind blowing to read about - and literally mind blowing for some of those who emerged for a time from the effects of their meningitis and then sank out of consciousness again. Sacks recorded the process as a scientist, and a man who is deeply concerned about the human condition and for his patients as people.It's a long book, but this is necessary to tell the stories of the group who trialled l.Dopa with the insight and compassion Sacks gives them.For me, the film came nowhere near the real meaning of the book, because it only told the story of a very few patients and focused on one. This made for human drama, but lost the scale of the double tragedy.

  • Charlie
    2019-01-05 18:44

    This is the astonishing true story of a group of people aflicted with a severe 'sleeping' sickness who were awakened for a while by a drug called L Dopa. It is full of personal moments of extreem grief and happiness and wonder. It is a story of clinical experimentation and individual care and understanding.A very good film of it has also been made with Robin Williams as Oliver Sacks. I think, as usual, the book is better than the film, but the film gives a good feel for the story line if not actually much of the detail.

  • Orsodimondo
    2019-01-15 19:53

    Tutti affascinanti i libri di Oliver Sacks, tutti ricchi di umanit��, mistero, dolore, intelligenza, speranza. Mi piacerebbe conoscerlo di persona.

  • Cain S.
    2018-12-16 16:45

    Movement and Sleep in ParkinsoniansThe idea that our bodies and minds are totally separate in their functioning and existence is a rather simplistic and erroneous view. The two are connected in several uncanny ways and influence the functioning of each other very profoundly. The object of this paper’s study is the book Awakenings by Oliver Sacks. We will concern ourselves with the way the biological and psychological processes of movement which correlate with Parkinson’s general symptoms. Our particular focus will be on the issues pertaining to Encephalitis Lethargica (sleep pattern disturbances) and the Parkinsonian (motion and rigidity) connection as it relates directly to the work of Sack’s book on Parkinsonian symptomatology in connection with Encephalitis Lethargica patients. When Encephalitis Lethargica first made its appearance in 1916-1917 it was not recognized as such because the symptoms were so very different in type and degree that it was not possible to generalize them as belonging to one condition; in fact, it seemed like several new diseases had come about at one time (Sacks, p. 12, 1991). Although there were smaller sporadic bursts of this sickness prior to 1916, there was never so much wide spread incidence and deaths of one third of patients suffering from sleeping sickness related complications (Sacks, 1991). The patients typically suffered by way of becoming fixed in a listless awareness, though they were conscious they could not act based on this consciousness, and were made statuesque (Sacks, p. 14, 1991). This immobility was caused by a negative influence which created an absolute resistance to the will of the patient, it was found that in phases Encephalitic patients could speak in a circular and restricted way; alongside this phase, involuntary movements of a variety of kinds were also observed (Sacks, p. 16, 1991). That the condition of Post-Encephalitic patients was not entirely physiological was established by the invariance of symptoms across cases with and without lesions on certain areas of the brain, and it was understood that there were other reasons which played part too (Sacks, 1991). Sacks also focuses on the environment of the hospital (Mount Carmel’s) as being of importance in the way it enhances or deteriorates the patient’s reactions to treatment procedures; often “…giving them a sense of being people, and not condemned prisoners in a vast institution…” could play a part in improving the patient’s overall health (Sacks, p. 26, 1991). Mazurkiewicz’s theory of psychophysiology holds that feelings are independent of thought processes and that they help interpret the way in which a person responds to objective impressions created by his interaction with stimulus (Kokoszka, 2007). In Kokoszka’s account of Mazurkiewicz’s “scale of dissolution” the symptomatology associated with illness in general marks a patient’s regressive and inadvertent behavior as ‘a shallow neurotic dissolution which does not disturb deeper levels of personality…” but this does erode the loss of control on actions such that excessive excitement cannot be suppressed and actions are made inconsistent (Kokoszka, p. 17, 2007). This is peculiarly interesting because patients of Post Encephalitic Parkinson in Sack’s book represent a wide spectrum of inadvertent and uncontrolled action, with a low ability of control while maintaining whole personalities. Our first case for analysis, related to movement, is that of Leonard L[1]., in Awakenings, who had lost all mobility due to his Parkinson’s condition, and could make very limited movement with one hand making him dependent on his mother for all basic things (Sacks, p. 203, 1991). He had the facility to spell out small messages using which he could communicate with others, but for his handicap he was profoundly intelligent and quick witted (Sacks, 1991). Sack’s understanding of the nature of restriction of movement that comes from Parkinson’s comes from Leonard’s ability at describing these in forceful and vivid metaphors; at one time he said it was like “the goad and the halter” which impelled him to action and then stopped him back (Sacks, p. 204, 1991). The main merit of the theory of psychophysiology as developed by Mazurkiewicz is that it can account for the overall sphere of human activity to be contained within the neurological and psychical thus allowing psychiatric practitioners to take active part in the rehabilitation of physiologically challenged patients (Kokoszka, 2007). Sack’s would agree that that humane treatment encompasses the catering to natural instincts of patients as human beings, and that within the organization of hospitals this should be a point of orientation while determining policies[2]. The distinction between ballistic and corrected feedback of movements by muscles is a vital capability which allows convenient motions through acts which require more or less accuracy and skill according to feed back from the senses (Kalat, p. 231, 2009). The motor programs which facilitate fixed movements and actions such that they can be done without thought (Kalat, 2009), but for a patient with Parkinson’s like Leonard L. this is not the case and being 30 years of age he was still infantilized and depended on his mother to change or bathe him (Sacks, 1991). But after his initial awakening on L-Dopa when he was able to move freely and express his inner life, he suddenly relapsed into over activity in the sense of losing control over corrected feedback movements (Sacks, 1991). This was also the time when his feelings of relief and happiness had reached a pathological pitch; he was grandiose and over-excitable without control and curb on his feelings (Sacks, p. 210, 1991). Thus, the connection between mind states and motor activity seem to be interacting at the sites in the brain where ballistic and corrected movements are coordinated with sensory stimulus. Parkinson’s disease is a disease of the basal ganglia, more specifically the region called corpus “…striatum” which “receives excitatory input from several areas of the cerebral cortex as well as inhibitory and excitatory input from the dopaminergic cells of the substantia nigra pars compacta (SNc)” (Hauser, 2011). The deficiency of dopamine is one of the reasons of this disease (Hauser, 2011), however it cannot account for all the symptoms created in terms of cognitive functioning by the Parkinson disease (Forgacs & Bodis-Wollner, 2004). Troster et al were able to establish that depression induced impairment of the brain organs connected with conceptualization and visuo-constructive tasks, thus showing the depression increased cognitive damage in Parkinson patients (Troster et al, 1995). Leonard’s condition too distorted his sense of space and location, perhaps because of the depressive/ repressive atmosphere of the hospital which could not accommodate his sexual frustrations, and he took on tics, palilalia and other involuntary motions with a sexual nature (Sacks, 1991). Sack’s recounts how his indiscriminating, indeed helpless sexual behavior caused him to be put into a punishment cell and deprived of company (Sacks, p. 216, 1991); thus given the situations which are to be maintained in the organization of a hospital make it difficult if not impossible to accommodate the human element of the patients. Lundkvist, Kristensson and Bentivoglio ( 2004) suggest that sleeping sickness is caused by a causative agent, a parasite called Trypanosoma brucei which affect the circumventrical brain organs leading to inflammation of hypothalamic structures, these areas of the brain affect the circadian rhythms which regulate sleep patterns in human beings (Lundkvist et al., 2004). Thus we see that a physiological agent introduces lesions in the brain which goes on to constitute the physical symptomatology of Encephalitic patients. The interaction between circadian rhythms and homeostatic processes which regulate sleep patters broadly may be affected by more than mere lesions in the brain as has been seen in research with mice and monkeys who showed that total sleep was unchanged in amount (Lundkvist et al., 2004). A disturbance in sleep and wakefulness patter may be brought about by the action of parasites which weaken the “flip-flop” function of the mutually inhibiting switch between brain mechanisms (Lundkvist et al, 2004). The switch between the homeostatic processes and circadian rhythms is dependent on the secretion of dopamine which mediates between the two interfaces and thus control sleep-patterns (Manglapus et al, 1999; Pozdeyev et al 2008). Thus in animals (quails and mice) it has been established that dopamine based interactions between circadian rhythms can change the sleeping pattern[3], perhaps such treatment for Parkinsonian patients too result in change of patterns of sleep. In any case Post Encephalitic patients in Awakenings have had a history of pathological sleep conditions (Sacks, p. 39, 1991). We will now consider the case of Frances D. because it is associated with our analysis of movement in Parkinson patients in Awakenings[4]. Beginning with insomnia and respiratory crises which were infrequent Frances started experiencing staring attacks and rigidity, or frozenness like she was entranced (Sacks, 1991). Post treatment with L-Dopa Frances experienced along with the stabilization of her motor rigidity some exacerbation of hypersensitivity, insomnia during attacks and an odd combination of opposing desires (sacks, 1991). Insomnia among Parkinson patients may be due to motor disability, depression or pain, additionally levodopa treatment may induce hallucinations (Hauser, 2004). The incidence of hallucinations in Parkinsonian patients generally causes more daytime sleepiness, as the incidence of REM sleep is reported, and hallucinators also reported daytime hallucinations (Arnulf et al, 1999). Frances too suffered from attacks which kept her awake, the intensity of the discomfort in breathing-breath holding which resulted sometimes in the increase of blood pressure to as high as 170/ 100, during treatment by L-dopa (Sacks, p. 47, 1991). Her symptoms however showed great intensification around specific dynamics other than psycho-physiological states, moods and circumstances: this was later confirmed as Dr. Sack’s presence on the scene which aggravated or brought on the symptoms (Sacks, p. 49, 1991). She also had monstrous dreams, or hallucinations which disturbed her mental state and caused her to sleep less soundly; in due course her occasional rigidity could be managed by the use of music which helped her break free from the trance (sacks, 1991). She kept a diary which was filled with the predicament of being a prisoner in a total institution which felt like being reduced to a child, but on the whole she is fit for a good part of the year and her attacks are less frequent and can be managed (Sacks, p. 64, 1991). Only during attacks her sleep was her sleep disturbed significantly enough for her to be awake at night, and groggy in the day (Sacks, 1991). Her almost normal situation depended on her mental adaptation to the situations he was put into once she was put up into the institution for good. But this adjustment is a matter of temperament, which is not the same with everyone, and because the effects of L-dopa on her were not totally unmanageable within the organizational means of the hospital (Sacks, 1991). Dreams with significant stimulating content and REM states are typical of Parkinson’s patients, though less frequently found in younger people, and it results in tiredness which needs to be treated (Lee Chiong ed., p. 163). For Frances this treatment worked out fine under the aegis of Dr. Sacks but it could not be the case for all patients in a terminal institution. This may be because of a variety of reasons like the etiology of the particular patient, the response to medication and also to a large extent the environment of such an institution. While it is understandable that Mount Carmel Hospital New York could not accommodate the sexual needs of Leonard L., but the general civility and cordiality accorded to all humans is the prerogative of all patients. Faced with their sickness and slim chances of complete recovery it becomes the foremost ethical concern to remove the unnecessary troubles from their life. Dr. Sacks often speaks in the book about how a little more social experience, excursions into the city for movies and other such experiences helped these patients immensely (1991). I agree that this is a necessary step, as also is the need of complete support from the patient’s family, without pathological attention between members like in the case of Leonard’s mother who encouraged his sexual suggestions underhand.

  • April Helms
    2018-12-28 20:56

    This completes my "read a book then watch the movie" fulfillment for the Book Riot challenge, so this is actually two reviews. I hadn't planned to use this one- I've actually seen the movie before (albeit some years ago). I was just on a science kick and had read Sacks' Musicophelia and really enjoyed it. But I really wanted to watch the movie again after reading this. I really wish I would have read the book first; usually I don't feel that strongly whether I read the novel or watch the movie first. But I picked up on so many details and so many lines from the movie that I missed the first time around because I'd read Awakenings. For those not familiar with either, Oliver Sacks is a doctor who, in the 1960s, worked with Parkinson's patients as well as patients suffering from post-encephalitic syndrome. From 1917 to the 1920s, there was an epidemic of encephalitis lethargica, or "sleeping sickness." Those stricken by this generally rare disease would go on to develop Parkinsonian-like symptoms later in life. By the time Sacks saw them, the majority of them were in a frozen state, unable to communicate and generally immobile. Brief moments of a dim "awakening" were noted with some stimulus, but these were the smallest flashes of light. Sacks tried what was then an experimental drug L-Dopa, with varying degrees of success. In his book, Sacks chronicles the stories of many of his patients (including a couple of patients outside of Mount Carmel and a couple of patients who had actual Parkinsons). Many of his patients (who were given a pseudonym) were able to write down their feelings when they were locked inside their immobile, unresponsive bodies as well as their feelings as they took L-Dopa and other medications. The book I read is a 1990 update, which included more footnotes than the original (according to Sacks) plus offered an update on the patients and his feelings about the movie. All but one of the patients had died by 1990. The surviving patient, whom he identifies as Lillian T., actually makes a cameo in the movie; I *think* I spotted her but am not sure. First off, about the book itself. I highly recommend it. Sacks' is a wonderful storyteller, and his narrative is generally conversational and easy to follow. He really makes an effort to portray his patients not just as clinical cases, but as real people. My one quibble was the copious amount of footnotes. Now, sometimes they had interesting information, but I felt they could have been worked into the narrative of the main part itself. Much of it just got too distracting. But this is minor. I loved reading his insights about the movie, which he seemed to be a fan of. He had especially high praise for Robert DeNiro, who portrayed Leonard, one of the patients (and there really was a "Leonard"; DeNiro's character was heavily based on the patient given that pseudonym). DeNiro's acting and portrayal of a post-encephalitic patient fooled Sacks himself, by his own admission. Sacks also marveled at Williams' talent for mimicry, at how well the actor got the mannerisms of the doctor (Williams' character Dr. Sayer is a fictional portrayal of Sacks himself). There are many details, many lines that come straight from the pages of the book and from Sacks' notes. The demand for a steak. The feeling of being caught in a sort of time warp. In one patient's case, the despair of knowing his family had essentially fallen apart. The card game. Catching the ball. Sometimes the family's not-so-positive reactions (captured by Leonard's mother) All of these are details from various cases. Really, I was stunned how true to the book the movie was, and Sacks while acknowledging that some liberties were taken with the facts, stated he was thrilled with how the movie got the feelings, the emotions right.There were, of course, some differences. I can, for the most part, understand why the differences were made for the movie, which I enjoyed even more the second time around. One, as Sacks notes, there was no major "Awakening" one night of all the patients. The patients were all given L-Dopa at various time spanning at least a couple of months. However, Sacks said this moment captured the feeling of what it was like to watch a patient who had been unresponsive for decades walk, talk, eat, laugh and interact with the world. One minor detail also is why L-Dopa was started: It was, indeed, very expensive when the drug first came out but by 1969, the price had fallen enough to make a wide testing feasible. Again, minor point and the solidarity of the staff made for a great moment. The only major difference I saw between the book and movie that bothered me a little were the reactions of the patients to L-Dopa, although I will confess I honestly don't know how they could have done this more honestly without making a four-hour movie or making it very confusing for the viewer. In the movie, L-Dopa is shown to wear off in a way (at least that is the impression I got), and all the patients eventually reverted back to their inert state. I was left with the impression the first time around was that L-Dopa was ultimately a failure. What actually happened is a heck of a lot more complicated. The truth is, the response to L-Dopa was all over the map. A couple of the patients responded extremely well to it, and were able to live out more or less normal lives. A few patients responded well at first, then developed other problems but with a dose adjustment managed to strike a medium between being catatonic and flying off the walls, having uncontrollable tics or other complications related to the drug. Some, after a period of "awakening" went on to develop complications that, even with adjustments, never entirely went away. These patients tended to develop a sensitivity to L-Dopa. Some developed coping mechanisms, but others were left to struggle with tics, uncontrolled movements, sleeplessness, emotional outbursts and more. And for a couple of patients there was no therapeutic benefit at all; Sacks described one of those cases as "catastrophic" and you could tell from his writing he really questioned himself and his tests after this sad case.So I guess my final verdict is this: both the movie and the book are excellent. Do understand the movie, by necessity, does take some liberties with the facts (and it even advertises itself as a fictionalized version of events so there's no intentional ploy at dishonesty here). I do recommend, if possible, that people read the book first because there are so many details in the movie that come from real life.Currently reading: Brave New World, by Aldous Huxley.

  • Claudia
    2018-12-31 18:53

    Sacks must be brilliant...allusions from science (of course), but also art, literature, philosophy...he connects them all.Summer of '69 was a busy one: Woodstock, Apollo 11 to the moon, and L-dopa tried on Parkinson's patients in a small eastern hospital. Patients whose Parkinsons was brought on by flu epidemics in the 20's and 30's, and who had lived as prisoners of their bodies since then.He tells the story of each patient...his or her past, and the course on L-dopa...in the epilogue he continues the stories with the sad deaths of many of them.He tells the story of AWAKENINGS on stage and film, and what each presentation brought to his understanding.I listened to these stories, knowing the wonderful awakenings would all end badly...I wanted Sacks to stop...But as the story continued, he convinced me that even if the awakenings were temporary, they brought new richness to the lives of his patients.

  • Kenneth Rathburn
    2018-12-18 21:52

    Oliver Sacks' book about a group of mental patients who undergo an experiment goes through a wide variety of emotions, all of which contribute feeling and power to one of the greatest stories I've ever had the pleasure of reading. What we're provided is a tale that begins with mild interest, shortly becomes heart-warming and, before long, entrancing before the last chapters conclude a read that's just too great to spoil. This is one of those few books that honestly made me look at life and the privileges those of us "normal" people have with gratitude but also disdain. It's a strong emotion, but tough to explain without giving the details and overall plot away. The awakened patients in this book become vivid in a wide spectrum during the middle act and make the experience of reading all the more enthralling. To put it simply: easily one of the best books I've read.

  • Erik Graff
    2018-12-28 17:59

    For viewers of the motion picture of the same name or those only familiar with Sacks' collections such as The Man Who Mistood His Wife for a Hat (1985), this book may come as a bit of a surprise. Published in 1973, Sacks was still very much writing as a professional neurologist and had not yet fully found his authorial voice. While still an interesting and thought-provoking tale, this book has much more the dryness, and critical apparati, of the academy.

  • Aaron Wolfson
    2018-12-16 22:46

    (This analysis also appears on my blog, Profound Reading.)What most struck me about reading Awakenings was how little I knew about Parkinsonism. I thought it was just a shaking disease, a “fact” I “learned” from the two most famous people with Parkinson’s, Muhammad Ali and Michael J. Fox.In truth Parkinson’s is so much more; it’s probably among the most variable, elusive disorders known to man. Common symptoms include rigidity, catatonia, masking (expressionless face, voice, or posture), blocking, sleep disorders, and much more. Clinically called akinesia, but more expressively described by Sacks:There are many different forms of akinesia, but the form which is exactly antithetical to hurry or pulsion is one of active retardation or resistance which impedes movement, speech, and even thought, and may arrest it completely. Patients so affected find that as soon as they ‘will’ or intend or attempt a movement, a ‘counter-will’ or ‘resistance’ rises up to meet them. They find themselves embattled, and even immobilized, in a form of psychological conflict — force against counter-force, will against counter-will, command against countermand.However, this is only one side of Parkinsonism, as the quote above hints at. The “hurry or pulsion” (clinically akathisia) is actually the first quality of Parkinsonism described in the 1800s. Hurry is also called in the literature festination, an adroit concept that Sacks calls “perhaps the most characteristic feature of Parkinsonism.”Festination consists of an acceleration (and with this, an abbreviation) of steps, movements, words, or even thoughts — it conveys a sense of impatience, impetuosity, and alacrity, as if the patient were very pressed for time; and in some patients it goes along with a feeling of urgency and impatience, although others, as it were, find themselves hurried against their will.Thus it seems to me that the major characteristic of Parkinsonism is a struggle with an inner force that is not one’s own, that alternately urges activity or confounds it, with little in-between (“in-between” being a state of control — the state we think of as normal). It’s almost impossible to imagine what this must be like. Sacks is an extremely empathetic physician and writer, and he takes pains to try to describe what it’s like to have Parkinson’s. However just as often, its his patients themselves who provide the most eloquent metaphors (for metaphor is the only vehicle we really have for understanding this).[It is] like being stuck on an enormous planet. I seemed to weigh tons, I was crushed, I couldn’t move. — Helen K.I think of a map; then a map of that map; then a map of that map of that map… Worlds within worlds within worlds within worlds… Once I get going I can’t possibly stop. It’s like being caught between mirrors, or echoes, or something. Or being caught on a merry-go-round which won’t come to a stop. — Rose R.Sacks’s patients, whose case histories he recounts in Awakenings, are a special group of Parkinsonian patients called post-encephalitics. They are the survivors of the great sleeping-sickness epidemic of 1916-27, which I’d never heard of before. (Mencken: “The epidemic is seldom mentioned, and most Americans have apparently forgotten it. This is not surprising. The human mind always tries to expunge the intolerable from memory, just as it tries to conceal it while current.”)The sleeping-sickness, actually a viral disease called encephalitis lethargica, struck no two patients in exactly the same way — this baffled the medical community. Many sufferers slipped in to irreversible comas, while others became so aroused that they died of insomnia. Those who didn’t die tended to fall gradually into a deep Parkinsonism, especially of the “frozen” variety, and had to be institutionalized. Sacks epitomizes their dreadful state with a quote from Donne: “As Sicknes is the greatest misery, so the greatest misery of sicknes, is solitude… Solitude is a torment which is not threatened in hell itselfe.”I ceased to have any moods. I ceased to care about anything. Nothing moved me — not even the death of my parents. I forgot what it felt like to be happy or unhappy. Was it good or bad? It was neither. It was nothing. — Magda B.This is when Dr. Sacks appears. In 1966 he arrived at a hospital in New York, where he oversaw a ward of about 80 post-encephalitics. He soon learned about a new so-called “miracle drug” called L-DOPA, which promised to reverse the effects of Parkinsonism. After putting it off for two years, he began starting his patients on it in 1969.L-DOPA’s effects on the post-encephalitic patients were instant and incredible; it generated the titular “awakenings” that have become almost famous, much more famous than what really happened. In actuality the awakenings were short-lived, and patients soon reacted to the drug in all sorts of bizarre and different ways, with the common thread that each saw a resurgence and even intensification of Parkinsonism. Many had to stop taking L-DOPA, after which they became even more confined than they’d been pre-DOPA. I was reminded of Charlie Gordon’s fate in Flowers for Algernon: was it worth it to experience the highest of highs, only to sink back to the depths below, or was it better to have gone through none of it at all?Sacks takes us through the case histories of a selection of these patients, and he shows us how they progress through three stages of L-DOPA. We experience their explosive reactions to the drug (“awakenings”), their “tribulations” with it after the adverse reactions appear, and for some, “accommodations” — these patients managed to achieve a homeostatis on L-DOPA that gave them a somewhat-normal life again.For the latter, these immensely strong individuals, the journey from encephalitis through L-DOPA strikes me as a characteristic example of Joseph Campbell’s hero’s journey — only for them, the period of wandering in the wilderness lasted decades. Alternatively, the three-stage sequence of response to the drug could be its own, highly-compressed example. The post-encephalitic Parkinsonian hears the siren call of L-DOPA, which calls her forth into an uncharted space, where after an initial elation, she endures the harshest tests of her will and character, to ultimately persevere and return to the sphere of Parkinsonism, eternally wise and unbreakable.Sacks reaches his greatest heights when discussing what the existence of Parkinsonism (and disease generally) means for our conceptions of life and “being-in-the-world.” Reading him made me grateful for my capability to move in and manipulate my own space — so easy to take for granted.The terrors of suffering, sickness, and death, of losing ourselves and losing the world, are the most elemental and intense we know; and so too are our dreams of recovery and rebirth, of being wonderfully restored to ourselves and the world.…Common to all worlds of disease is the sense of pressure, coercion, and force; the loss of real spaciousness and freedom and ease; the loss of poise, of infinite readiness, and the contractions, contortions, and postures of illness: the development of pathological rigidity and insistence.…Health is infinite and expansive in mode, and reaches out to be filled with the fullness of the world; whereas disease is finite and reductive in mode, and endeavors to reduce the world to itself.But what I gained most from Awakenings was learning about the greatest gift one can give to a person with Parkinson’s: companionship. It is togetherness that frees them from their inner constraints, so they may move freely again. Sacks describes patients who are rigid and unable to walk, until they receive the slightest touch — this seems to revive them, recall them to the world, and impel them to get up and go. Patients who normally struggle to walk without festinating can swagger gracefully down the corridors if they are walking with someone.I can do nothing alone. I can do anything with — with music or people to help me. I cannot initiate, but I can fully share. You “normals,” you are full of “go,” and when you are with me I can partake of all this. The moment you go away I am nothing again. — Edith T.When you walk with me, I feel in myself your own power of walking. I partake of the power and freedom you have. I share your walking powers, your perceptions, your feelings, your existence. Without even knowing it, you make me a great gift. — Edith T.Feeling the fullness of the presence of the world depends on feeling the fullness of another person, as a person; reality is given to us by the reality of people; reality is taken from us by the unreality of un-people; our sense of reality, of trust, of security, is critically dependent on human relation.How profound, how amazing it is to be “full of ‘go.'” This is a lesson that applies to all aspects of life: if you have something, some quality or flair, that others don’t, do your best to use it and treasure it and share it while you can. Make connections. Envelop yourself in fullness and reality.

  • Bob
    2019-01-05 21:05

    Summary: Chronicles the experience of post-encephalitis patients existing as prisoners in their own bodies in a trance-like state, who, when treated with L-DOPA, experienced dramatic "awakenings" nearly always followed by debilitating side effects, often resulting with withdrawal of the drug, and a return to their former state.From 1916 to 1927, there was an epidemic of encephalitis lethargica, or "sleeping sickness." The sickness often resulted in a period of profound lethargy, sometimes ending in a return to normal or nearly normal life. A number of patients experienced symptoms of Parkinsonism, leading to increasing paralysis and necessitating institutionalization. Many lived as prisoners in their own bodies, limited in movement and speech.Oliver Sacks, in this book chronicles his work with a group of such patients, some institutionalized for as long as forty years in Mount Carmel Hospital in New York. During the time that he was caring for them, a new drug, L-DOPA, began to be used with great effect on Parkinson's patients, and since these patients symptoms were similar, Saks, and other attempted to use the drug with them with dramatic, and ultimately, troubling, effects.After introductory chapters on Parkinsonism, sleeping sickness, Mount Carmel, and L-Dopa, he describes the patient history of twenty patients who he treated with this drug. It turns out they responded very differently than Parkinson's patients. Nearly all of them experienced "awakenings" where they regained the ability to move and speak. One patient, Leonard L. described the experience as follows:"I feel saved. . . I feel like a man in love. I have broken through the barriers which cut me off from love. . . . I have been hungry and yearning all my life, . . . and now I am full. Appeased. Satisfied. I want nothing more. . . . L-DOPA is a blessed drug, it has given me back the possibility of life. It has opened me out where I was clammed tight shut before. . . . If everyone felt as good as I do, nobody would think of quarrelling or wars. Nobody would think of domination or possession. They would simply enjoy themselves and each other. The would realize that Heaven was right here down on earth."Sadly, with few exceptions, these awakenings did not last but turned into wide awake nightmares. Coherent speech would become rushed faster and faster, and degenerate into repeating of words or phrases. "Tics" would appear and become debilitating. Movement would accelerate to the point that the person could harm themselves. Psychological changes occurred as well and a normal personality would generate into mania.The histories describe the heart-wrenching efforts to bring these symptoms under control by reducing dosages. Sometimes things were so bad that they had to withdraw the drug, leading to a return to a trance-like or coma-like state. He also describes three stages he observed patients going through: awakening, tribulation (side effects is too mild to describe this stage) and accommodation. Some are able to resume L-DOPA, and some not. What is striking is how they come to terms with their dashed expectations and suffering. Leonard writes, "I am a living candle. I am consumed that you may learn. New things will be seen in the light of my suffering."Sacks also observes how significant the human connection is with his patients, and how they do significantly better when there is at least one person in their lives with whom they connect, whether someone on the ward, or a family member or friend. For one patient, the chance to cobble shoes again enhanced his physical well-being and checked his descent into profound Parkinsonism.He concludes with some profound reflections on the nature of disease and the human personality. Sacks then includes series of fascinating appendices at the end of the book exploring the history of "sleeping sickness," the past experiences of "miracle drugs," and the electrical basis of awakenings. Two of the most fascinating were his studies of the different perceptions of space and time of his patients, and the application of chaos theory to understanding patient responses to L-DOPA, which did not follow any orderly progression.The last appendix is an account of the various radio, stage, and screen adaptations of Awakenings. Most notable is his description of working with actors Robert De Niro and the late Robin Williams and director Penny Marshall on the film version of Awakenings. He pays a wonderful tribute to their craft in getting "inside" what it was like to be one of these patients and the portrayal of fifteen "awakenings" at once and the chaos, brilliantly choreographed by Marshall.Sacks gives us a narrative that helps us understand the often heartbreaking process of medical research, where advances and setbacks often come together, and where, more than science, the bond between doctors and other caregivers and patients remains paramount, whether treatments effect cure or not. Through one rare condition, Saks gives us a lens into the human condition we all share.

  • Ann
    2018-12-24 19:55

    It was not at all what I expected. While the subject matter could interest a lay reader, it was written in extremely technical medical language, and there were times where I was sure I would give this book only 1 star, if I ever managed to finish it. My eyes would glaze over page after page of words that I didn't recognize and were not in the Kindle's built-in dictionary. The glossary in the back is not easy to access in an e-book. Dr. Oliver Sacks writes about his experience treating patients with post-encephalitic Parkinsonism years after having been victims of the great sleeping sickness epidemic at the end of World War I. Dr. Sacks cared for these patients before and after the advent of the alleged "miracle drug" L-Dopa (levodopa) in 1969, which, had remarkable "awakening" effects that gave new hope to his patients but were soon countered by intolerable adverse effects. Reactions varied among individuals, and the main body of the book is devoted to 20 case studies. I liked the fact that Dr. Sacks regarded his patients as whole persons and came to love them. My favorite part of the book was in the Appendix, where Dr. Sacks discusses the making of several films and dramas based on his book. Talented actors (such as Robert De Niro, who played a starring patient role in the 1990 movie) did intensive research, including direct contact with patients, to learn to play their afflicted characters convincingly, achieving astounding success, according to consulted patients themselves. While this segment was the most interesting to me, I could not have appreciated it without having the rest of the book. There were other rewards as well, so I am glad I persevered with this challenging work.

  • Andreea
    2018-12-29 22:45

    When I started to read “Awakenings” I was prepared to discover a number of medical cases of patients that suffered from the post-encephalitic syndrome. I was acquainted with the opinion of Dr. Sacks regarding the presentation of medical results not only in a pure mathematical form, but also as individual cases. Because you can not reduce someone’s context and being to just numbers. However, this book is so much more. It is a book of discovery from several points of view. We discover Dr. Sacks applying what he preaches: trying to understand the context, the “I”, of each and everyone of his patients, going beyond just administering x mg of this or y mg of that medicine and waiting for the results. He listens to his patients and their families. He tries to understand what triggers their behaviour and what the hospital can do to make their lives better. He always puts the welfare of the human being first. And he allows us to discover his patients as human beings, by presenting their disease in their own words.The book went through several editions since it was first published. With each new edition Dr. Sacks tried to improve it and make it more readable. Not until the last pages of the book did I understand that he wanted to tell the story of this peculiar disease to as large an audience as possible. And even after witnessing so many things with his patients, Dr. Sacks can still be surprised. He saw several adaptations of his book as theatre and radio plays, documentary and Hollywood movie. He impersonated his real self in the radio play and served as a “consultant” for Penny Marshall’s “Awakenings” starring Robin Williams and Robert De Niro. He was impressed by the way actors studied their roles and especially by Robert De Niro’s dedication. Not only did he talk to the last survivors of the post encephalitic syndrome, but he was absorbing and practicing their states even in real life:Ed W. told Bob that sometimes he might be completely frozen for hours, completely unable to get out of his chair or bed. Bob told me that he would sit and thing of being frozen like this, of not being able to get out of bed - he would think about this intensely, almost hypnotically for hours; he would imagine the inner quality of frozenness, at such times. […] One of the greatest, and most paradoxical, challenges of all was imagining nothingness, which Leonard L. himself, and many other post-encephalitics, would often experience. Bob and I spent hours talking about nothingness, and the different sorts of nothingness patients might experience; this was a challenge Bob took very seriously - he quoted Beckett to me once: ‘Nothing is more real than nothing.’

  • Abbi
    2019-01-09 19:03

    Favorite tidbits:A third of those affected died in the acute stages of the sleeping-sickness, in states of coma so deep as to preclude arousal, or in states of sleeplessness so intense as to preclude sedation...One thing, and one alone was (usually) spared amid the ravages of this otherwise engulfing disease: the “higher faculties” – intelligence, imagination, judgment, and humor.As sickness is the greatest misery, so the greatest misery of sickness is solitude...solitude is a torment which is not threatened in hell itself.Descend lower, descend only into the world of perpetual solitude, world not world, but that which is not world, internal darkness, deprivation, and destitution of all property, desiccation of the world of sense, inoperancy of the world of the spirit...The pathogen is nothing; the terrain is everything.If only I could find the eye of my hurricane...One must drop all presuppositions and dogmas and rules – for these only lead to stalemate or disaster; one must cease to regard all patients as replicas, and honor each one with individual attention, attention to how he/she is doing, to his/her individual reactions and propensities.It is characteristic of many neurologists (and patients) that they mistake intransigence for strength, and plant themselves like Canutes before advancing seas of trouble, defying their advance by the strength of their will.As the central concept of disease is “dis – ease”, the central concept of therapy is ease; everything which promotes the ease of the patient reduces his/her pathological potentials, and assists the fullest coming to terms which is possible.Kinship is healing; we are physicians to each other – a faithful friend is the physic of life.And the end of all our exploring will be to arrive where we started and know the place for the first time...Every disease is a musical problem. Every cure is a musical solution.The Parkinsonian is lost in space and time – bereft of any inner scale, or metric, at all; or with his scales, his inner metrics, fantastically capricious, warped, and unstable.Only great pain, the long, slow pain that takes its time compels us to descend to our ultimate depths...I doubt that such pain makes us “better” but I know it makes us more profound...

  • Rose
    2019-01-15 22:42

    I was excited when my book group selected this book, as I remembered loving the feature film it inspired. However, my enthusiasm was quickly dampened within the first several pages -- not because of the content, but because of the writing style I encountered. The text is so full of medical jargon and clinical explanations (including footnoted expansions of the text which often take up close to or more than half of the printed page) that reading it was WORK, not pleasure. After the introductory material and the first 8 of the patient case histories, I moved on to the supplemental material about how director Penny Marshall and actors Robin Williams and Robert De Niro prepared for the feature film. That part, at least, was readable -- and quite enjoyable, especially as I had just re-watched the movie the night before.It's evident to me that Dr. Sacks had a far different audience in mind as he was writing this book than the general reading public. If he intended this book to be read by a wider audience than those in the medical sciences, he either missed the mark or was grossly misled by his editor in thinking he had reached it. I found the subject matter fascinating, but obscured by the language he used to report his experiments with using L-Dopa as treatment for post-encephalitis lethargica patients. The book reads like a clinical journal, not a story. And while the book is titled "Awakenings," neither the patients nor Dr. Sacks himself comes to life on the page. Although the movie is not an exactly accurate portrayal of this amazing event in the history of treating Parkinsonian-like symptoms and victims who had been catatonic for 30 years of more, it is a more human, enlightening treatment of Dr. Sacks's work with these people. I'd suggest seeing the movie first, then reaching for the book as additional reference material if you want to try to learn more about the experiment or the encephalitis-lethargica pandemic of the 1920s. I had such high hopes for this book. Sadly, they were dashed. Perhaps another writer somewhere can turn this report into a narrative which more of us can appreciate, because the story of what happened is certainly worth telling -- and reading about.

  • Jared Gillins
    2018-12-27 18:50

    I watched the film version of "Awakenings" when I was 10 or 11. It was the first movie I cried in--a profound moment in my development. Now, over 20 years later, I've finally read the book that inspired Penny Marshall's adaptation.Oliver Sacks is a remarkable writer, especially for a physician and scientist; his prose makes his real-life characters vividly alive in my mind. His approach to this book was unique, especially in 1973 when it was first published. It is essentially a series of medical case-histories, but written for a popular audience. Sacks' approach was brilliant in that it retained a level of professionalism that entrenched his work with the medical community, yet it had a level of readability that made it reach far into the public. It thus raised overall levels of understanding about Parkinsonism and other broader medical issues.The application of broader medical topics to Sacks' discussion of post-encephalitic Parkinsonism is really the true genius of the book. After completing his case histories, Sacks engages in a discussion of the treatment of disease (using the patients at hand as a launching point) that calls for a revised approach to medicine for both doctors and patients. I won't go into it here, but I will say that he makes some very important and thought-provoking points. Give the book a read.I held back one star because in spite of the book's surprising readability, it still has the faint earmarks of the work of a doctor. At times the writing wanders into the clinical, at which point Sacks usually reins it in, but a bit too late. He also uses a LOT of unfamiliar medical and neurological terms that make certain parts--especially toward the beginning--difficult to understand. There is a glossary of terms in the appendix, but it is not comprehensive enough.Still, I highly recommend this.