Awakenings by Oliver Sacks (PDF)

Description

Awakenings–which inspired the major motion picture–is the remarkable story of a group of patients who contracted sleeping-sickness during the great epidemic just after World War I. Frozen for decades in a trance-like state, these men and women were given up as hopeless until 1969, when Dr. Oliver Sacks gave them the then-new drug L-DOPA, which had an astonishing, explosive, “awakening” effect. Dr. Sacks recounts the moving case histories of his patients, their lives, and the extraordinary transformations which went with their reintroduction to a changed world.

User’s Reviews

Reviews from Amazon users which were colected at the time this book was published on the website:

⭐Carina ChiquitoNeuro 105Professor Kreher4/19/13Awakenings Encephalitis Lethargica was a sleeping sickness that had similar symptoms to those of Parkinsonism. Striking after WWI, encephalitis lethargica became a worldwide pandemic. In the United States, neurologist Olive Sacks sought to find solutions for symptoms of encephalitis lethargica. He worked with many patients who had encephalitis lethargica and distributed doses of L-DOPA, a drug commonly used to treat symptoms of Parkinson’s disease. He believed L-DOPA would help reduces symptoms of encephalitis lethargica because most of the symptoms were similar to those of Parkinson’s disease. Throughout the time he was distributing trials of L-DOPA, Oliver Sacks recorded many of his experiences with his patients. He would record comparisons of the patient suffering from encephalitis lethargica before taking L-DOPA and their responses after taking it. His recordings became known as one of his famous novels Awakenings. In his novel Awakenings, Sacks describes his experiences with post encephalitic patients upon taking L-DOPA. He begins his novel with a prologue describing and making connections between Parkinsonism and encephalitis lethargica and the aftermath of those who suffered from the sleeping sickness. He then continues with how life was for patients at Mount Carmel, an institution for people who were mentally ill followed. The rest of his novel, Awakenings, is similar to a journal entry; an entry for each of the patients he worked with. He described the patients and their behaviors prior to taking L-DOPA and their behaviors after taking it. Sacks began his Awakenings entries with Frances D, one of the various patients Sacks worked with at Mount Carmel. He begins her story by mentioning how she became a victim of encephalitis lethargic at the age of fourteen. He continued to describe her state of being as deteriorating in which she became less capable of controlling her muscles from becoming stiff for long periods of time. Sacks also mentioned how there was a point at her life when everything seemed to be normal and she was even working, but that period did not last long. Shortly after, her symptoms worsened, and she had to be institutionalized. On June 25, 1969, Frances was given a dosage of L-DOPA. Five days after being started on L-DOPA, Frances still seemed to have symptoms of tremors and excessive muscle movements. On the eleventh day of her trial, her symptoms began to reduce and her speech was a bit clearer than before.As she continued to receive her doses of L-DOPA, Frances’ symptoms began to reduce, but at the same time, she began having negative outcomes from taking the drug. Her breathing and fidgeting were becoming more and more irregular. Because her breathing seemed to worsen, Sacks was forced to discontinue the distribution of the drug, but Frances insisted on the benefits she was receiving because of the drug. Instead, Sacks reduced the dosage.Sacks’ purpose of distributing the drug was to see whether the use of L-DOPA would reduce symptoms of encephalitis lethargica. As described in his novel, patients suffering from the sleeping sickness did show some improvements with the use of the drug. The drug is meant to replace the loss of dopamine levels in the person’s brain. In class we have learned that dopamine is a neurotransmitter and it helps send signals from one cell to another. Because a person suffering from encephalitis lethargica has low dopamine levels, they tend to experience tremors. With the help of L-DOPA, dopamine levels increase and the tremors are reduced. This helps explain neurotransmitter replacement therapy.Sacks’ entries of prescribing doses of L-DOPA describe relationships to what we have learned in class about pre-synaptic and post synaptic neurons as well as brain structures. Encephalitis lethargica is known to attack parts in the brain that help produce dopamine. Similar to what we learned in class, when a part in the brain is affected its function will decrease causing severe disorders. We have also learned that dopamine is an important neurotransmitter that has important role in brain function. Some of these functions include roles in a person’s behavior as well as voluntary motor movement and memory. We have also learned about the relationship between the pre-synaptic neuron and the post-synaptic neuron. In a normal neuron, you will see a balance and normal production of dopamine. The pre-synaptic neuron will release dopamine to the dopamine receptors in the post-synaptic neuron. When a person suffers from encephalitis lethargica, similar to Parkinson’s disease, the brain does not produce enough levels of dopamine resulting in a shortage of dopamine levels released from the pre-synaptic neuron to the post-synaptic neuron. Overall, I really enjoyed reading this book for various reasons. In regards to Oliver Sacks, he strongly believed that prescribing L-DOPA to treat patients who suffered from encephalitis lethargica could have improved symptoms. In his entries he was able to support his beliefs, although some of the cases when prescribing this medication did not turn out as he had planned. When reading Awakenings I noticed how emotional some of the entries were. In regards to the patients, it was heartbreaking to read about the lapses they went through even after going through medication and rehabilitation. I felt as though the book showed what it really means to have motivation. In Frances’ case, she insisted on receiving doses of L-DOPA regardless of the fact that it was affecting her negatively. She wanted to get better and be able to live a normal life as she used to. Unfortunately because her health was at risk, doses of L-DOPA were cut and she relapsed into a “sleep” again. When patients relapsed after taking the medication, it disproved Sacks’ beliefs that there would be long term positive outcomes upon using L-DOPA.This book was also educational in which it taught me so much about how a drug developed to treat a specific disorder has multiple purposes and can help treat another disorder. For example, we learned how L-DOPA is mainly used to treat patients who suffer from Parkinson’s disease, yet it is also used to treat Encephalitis lethargica. Because most symptoms of Encephalitis lethargica were similar to those of Parkinson’s, L-DOPA turned out to be a useful treatment. It would cross the blood brain barrier and convert itself into dopamine to help replace the dopamine that was lost. It also shows how the material in our class is relevant in terms of those who suffer from a p-psychological disorder as well as the relationship between pre-synaptic neurons and post-synaptic neurons.

⭐This is a very dense book. Almost as if it were written for neurologists and not the general public. The case histories were interesting.I preferred “The Man Who Mistook His Wife for a Hat”.

⭐Awakenings by Oliver Sacks; (5*);This is fascinating stuff!I am not nor was I ever a medical student nor have I ever worked in the medical field. But I am so thankful that I read this book & must say, even at the beginning of my thoughts & comments, that I highly recommend this work of Sacks. The man has a brilliant mind, very worthy of our appreciation.I could not have read this book, had I not read ALL of the preliminary notes which take the reader well into the book and give one such as myself a very good background before going into the case studies of these special patients.I found the book to be so much better than the movie, which I thought wonderful & which left me speechless!The “sleepy sickness” that masks itself as Parkisonism would be difficult to garner understanding from without those previously mentioned notes. Oliver Sacks is a gifted writer. His prose is often times overly medical but again, please read the notes before beginning the case studies. The beauty of his words in regards to how medicine should be practiced and how the overly technical aspects of medicine are denying the original feeling & healing that is the true basic of the medical practice have made this book a must read for all those going into the medical field. I could go on and on but will just say: Please read this book if you have any interest in an extraordinary disease and the extraordinary processes which both the patients, other doctors, nurses & medical personnel go through long with Dr. Sacks.__________________________________________________​From Wikipedia regarding the “sleepy sickness”:”Encephalitis lethargica or von Economo disease is an atypical form of encephalitis. Also known as “sleepy sickness” (distinct from tsetse fly-transmitted sleeping sickness), it was first described in 1917 by the neurologist Constantin von Economo and the pathologist Jean-René Cruchet. The disease attacks the brain, leaving some victims in a statue-like condition, speechless and motionless. Between 1915 and 1926, an epidemic of encephalitis lethargica spread around the world. Nearly five million people were affected, a third of whom died in the acute stages. Many of those who survived never returned to their pre-existing “aliveness”. “They would be conscious and aware – yet not fully awake; they would sit motionless and speechless all day in their chairs, totally lacking energy, impetus, initiative, motive, appetite, affect or desire; they registered what went on about them without active attention, and with profound indifference. They neither conveyed nor felt the feeling of life; they were as insubstantial as ghosts, and as passive as zombies.” No recurrence of the epidemic has since been reported, though isolated cases continue to occur.”

⭐The book arrived by post in the time predicted, with ecological packaging: cheap at £3.47 with free P&P. However, the condition was disappointing, five pages having bent corners, the cover with creases and ragged edges. This does not correspond to the description ” Used – Very Good – This book has been looked after very well and will have minimal signs of use, if any.” On the other hand the description did in contradiction admit “Damaged cover. The cover of is slightly damaged for instance a torn or bent corner.”

⭐I read this book after watching the film awakenings. I found it both fascinating and heartbreaking. The individual patient stories gripped me but I honestly found it hard to keep up with the medical side of the book. Would still recommend.

⭐For the price I paid I had expected the book to be new but it was not. As for the content of the books, you cannot go wrong with Oliver Sacks for such an eye-opening account of the oddness that is the human brain.

⭐The case studies are fascinating. But the intro and postscript are a yawn-fest. I think this is probably an interesting read for medics and not many others.

⭐Great work on neurologically damaged patients; a book of profound emotion and thought on human life and human nature with a powerful point about the central energy that we all possess and how our inner system can be so perturbed but also how the people described in the book find the resources to respond and decide what they want to live for or not. As a psychotherapis, I found this book illuminating.

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