Category Archives: Sacks, Oliver

Awakenings: Read from September 11 to 24, 2013

Not until I got the the very end of the book (the chapter dealing with stage/film/radio adaptations) did I became aware of the nearly ‘Klein bottle’ structure Dr. Sacks writes with and tries to explore in his patients here. The book, and the patients, begin with the outbreak of encephalitis lethargica, they survive, however, become severely Parkinsonian and are prisoners in their own bodies, yet to a person still retain their own uniqueness and can’t actually be defined by their disease. When they are ‘awakened’, each person is effected differently and often profoundly, sometimes uniquely each time they are given L-Dopa, and some even get better. Then the strange happens when the actors who portray these people, especially Robert DeNiro, almost become Parkinsonian themselves, to the point that Sacks can’t actually tell what’s going on. Just like many of the patients could almost ‘choose’ to get better or not, so too could the actors choose their own methods and the levels of profundity.

When these actors mirror back what Sacks studied, we get a strange picture of illness and health, of a sound mind and a hallucinatory mind, of the reality that the patients invented to survive and the imaginary the actors invented to achieve a great performance. I almost felt like Sacks wanted to hook up the actors to lab equipment and run a battery of tests on them to see if what some of his patients went through would mirror the test results of what the actors put themselves through.

And at the heart of all this is identity. Most profoundly, and the point Sacks truly wanted to make (and still makes) is that patients are, in fact, human beings who are not defined by a disease but are wholly just human beings who need the treatment from a doctor who treats them as a human being.

This is where the controversy comes in, too. Medical science is supposed to deal in cold, hard facts. A doctor does not get emotionally involved in their patients lives because that would destroy the objectivity of the professional. Or so they would say. I, like Sacks, disagrees. The WHOLE person must be treated and the person cannot be defined by what ‘ails’ them, but only by who they actually are: a person who needs to feel better.

Sacks shows how even among a small sample size of patients all suffering from the same basic root disease, post-encephalitis lethargica, they each present in completely different ways, revive in different ways (and sometimes not even at all) and each presented a totally unique set of medical circumstances. Up until Sacks these people had basically been wasting away in a ward in an old hospital in New York – a group of profoundly disabled, Parkinsonian patients with no hope for anything better. But after Sacks, they were at least given a chance to be seen as human beings, even if they didn’t actually get better.

And that couldn’t be more clear than in the case of Leonard who, at the very end, cursed his awakening as a cruel joke. How much more human could that be? Sure, we may dream up a more romantic, a more stoic role for ourselves if we imagined being in his place, but honestly Leonard was almost more than human in his imperfections and passions. He wasn’t just a man suffering from total disability; you can’t ‘define’ him that way because he was a complex human being with as many faults as pluses.

So finally what Sacks is getting at is the notion that we need to recognize the basic humanity in each of us, and especially the stranger to us. It is no wonder that the disease that Sacks wrote about first began claiming victims around the time of the WW1, a terrible war that brought the world together to kill itself. This disease was, sort of, a remnant of that terrible time, a reminder that to treat each other with un-humanity that we could suffer the same living-hell fate of having our own humanity taken away by doctors and loved ones while we rot in a useless body but with an almost perfect mind.

85% done with Awakenings

I’ll admit that I was much more interested in the case studies than I am in the deeper philosophizing that Sacks has ventured into, however, he does draw some very insightful conclusions that while maybe not therapeutic in a medicinal sense, are hugely important for all physicians to understand: and that is that the doctor is not a dispensary of physic but must treat the WHOLE patient and that all patients are unique

59% done with Awakenings

Through the numerous case studies up to this point in the book, it’s apparent that postencephalitic parkinsonism manifests itself uniquely in each person. Not only that, but many patients before going on L-Dopa (or going back on it), seem to intuit what will happen to them – and each time are proven, sadly, correct.

Sacks is very keep to bridge the gap between disease and patient and never separates the two.

42% done with Awakenings

If I had invented ‘Big Bertha’ for a story, Shakespeare, Hemingway, Tolstoy, and Joyce would have risen from the grave, come to my home, and taken turns beating the hell out of me for making up such a preposterous character. Not even the writers of Futurama would have accepted her.

That what makes her so amazing and unforgettable, just the sheer fact she really did exist.

35% done with Awakenings

Rolando’s story, for me, has been the most intensely personal. He’s someone who despite his sickness from such a young age, gave life a shot when he got L-Dopa. And he seemed so very human in a flawed and passionate way – his desires, his depressions and the way he died, like something from a novel. His story really touched me because of its rawness.

And to follow him with Miss H., it’s almost too much to believe

24% done with Awakenings

The second case study is Miss R., and here we learn first hand the horror of what it might be like to be so trapped in a body that no longer cooperates. Yet her mechanism of defense was of the most extreme apathy yet she never lost some innate sense of happiness when, after the L-Dopa, she ‘awakened’ and was able to deal with life again.

The end of her story is so literary, that it almost feels like fiction.

18% done with Awakenings

The first study is Mrs. B and Sacks’ decision to introduce her to us first is inspired because, as he puts it, though she was never a star patient, she is in many ways the best of us and for anyone who has been diagnosed with Parkinson’s, the best, plausible hope to be optimistic for.

In many ways reading this study is like stepping back in time to the 19th century when dr’s cared for the person, not just the body

8% done with Awakenings

I’ve been a huge fan of Oliver Sacks for years ever since I first discovered the great radio program on NPR, Radiolab, on which, over the years, he has been a frequent contributor and guest.

What interested me in Dr. Sacks was his deep well of humanity, an overflowing reservoir of empathy for the dispossessed and uniquely afflicted. He’s a champion for the unusual, an unusual that is common to us all, in a way.