Awakenings

By: Oliver Sacks

Narrated by: Jonathan Davis, Oliver Sacks

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.

PLEASE NOTE: Some changes have been made to the original manuscript with the permission of Oliver Sacks.

©1973, 1976, 1982, 1983, 1987, 1990 Oliver Sacks (P)2011 Audible, Inc.

Critic reviews

"One of the most beautifully composed and moving works of our time." ( The Washington Post)

interesting

fascinating, well written, and a good performance, but it did get a bit too repetitive and tedious to listen too with all the cases. but the ending was strong, so im glad I listened to the book.

Not my favorite, but grateful for it

I’ve been a fan of Dr Sacks for years, and so I was eager to read the book that made him famous. After reading the man who mistook his wife for a hat, anthropologist on mars, and on the move, I found this book interesting but excessively clinical. The language and vocabulary are less accessible than his later works. If you are a Sacks fan, it is a must-read. But if you are new to Sacks, there are better places to start.

Breaks free of clinical detachment

This book was one of the first by Sacks to make his reputation as a popular writer of forefront neuroscientific topics, which is unusual because of the rather high concentration of medical jargon in the case studies making up the major part of the book. He does explain what 'festination' and 'oculogyric crisis' is about, but you still have to keep the translations in mind when you encounter them later, while wondering whether you are properly picturing what they are like. The profound deficits many of the patients had made me wonder how they were able to stay alive for decades in the first place, consuming food and eliminating waste in perpetual sleeplike states. For each of the patients he starts out with a description of their life story before they came to his facility, the level at which they started prior to being treated with l-dopa, and then the evolution of their response to the drug almost always with pronounced near-miraculous recoveries and devastating relapses. After a few of these, you learn to appreciate the idea that they really didn't have much of a clue what was likely to happen, at first. After a few more, you learn that whatever you learn from the first half-dozen or dozen patients tells you practically nothing about what will happen the next group. And when you hear about the ones who, unlike the other famous ones, never actually experienced the full awakening and loss of Parkinson's symptoms, you begin to feel what makes this kind of life work incredibly tough to bear up under.

As I understand it, Parkinson's disease of the post-encephalitic and of the ordinary sort is still somewhat poorly understood fifty years after this pioneering set of trials. The idea is that administration of l-dopa, a precursor feedstock of the neurotransmitter dopamine, would compensate for the loss of the brain's ability to create the chemical on its own either due to an acute infection (the post-encephelitis lethargica cases which occurred as an epidemic in the 1920s) or some kind of autoimmune process (the conventional kind). The dopamine was then going to find its way to where it was needed by other brain structures, and the sole way the doctor had of regulating this was with the number of grams of l-dopa the patient would consume daily. There was no way of targeting the dopamine to the portions of the brain that would benefit from it and not the ones which would malfunction, causing hallucinations and tics and obsessive behavior, and since the chemical would persist in the system over time, once the undesired symptoms began to manifest there was no way to shut them down quickly. It sounds likely that the initial administration would show little effect, but as more and more was added, the patient would accumulate too much in their system and overshoot the optimum range. Most discouragingly, once the dosage had gone too far and was corrected, not everyone would be able to recover what seemed to be the best circumstances they enjoyed. A few of them even seemed to suffer permanent and crippling damage because of the regimen, which must have been a difficult thing to accept much as what happens with experimental and risky treatments of today. Maybe the most emotional part was what the patients would do and say when asked whether they wanted to continue, perhaps with a modified dosage or some other accommodation, to try to avoid Parkinsonian insensibility on the one hand and full-blown psychosis on the other. Some would ask to be taken off the drug entirely, while others would decide that the level of function the drug gave them, even with the severe side effects, was worth continuing.

There were two epilogues in the audiobook version I listened to. One was an update written about ten years after the author left off caring for this group of patients and had moved on to other postings. A very few of the original group of patients were still living by then, some still on l-dopa treatment and others having ended it. Accompanying these updates were a number of more-or-less philosophical ruminations by Sacks on what lessons he has gained over time from the experience of treating these individuals. The second epilogue concerns the behind the scenes notes connected with the Hollywood film inspired by the book and the case histories presented. The way the film actors and the director approached the depiction of the Parkinson's patients gave another glimpse of what it was like to try to take those individual's places. It will be interesting to watch the film (which I haven't seen yet) to see how closely the way I pictured the persons described matches their interpretations of the manifestations of disease and recovery.

I think that experiencing the remarkable stories of long-term institutionalization suddenly interrupted by a return to normal function, then setbacks, and more and more daunting challenges to maintain a balance is a good thing

One note on the audiobook version: there are many patients described in depth, always referred to by first name and last initial, and I thought it was difficult to keep them straight especially when the author returned to their cases, either when talking about another patient of his or in the epilogues. Since I didn't listen to the audio chapters in a continuous sitting, and since there would be only a few mentions of the patient's name, at the beginning and maybe sprinkled in among the rest of the text, it was easy to miss out on the association of the name to the specifics of the case. In a printed book or an ebook, it would be possible, although inconvenient, to look back and see what name was at the head of whatever chapter you were taking in. This is not a comment on the performance or the writing, only on a limitation of the medium.

Not for the average reader!

This book should come with a warning "for medically proficient readers". The book is a technically, very difficult book to read with terminology only known to people very knowledgeable in medical terminology. I was very disappointed in the lengthy and excessive language used which make this book barely a treat to listen to but rather a lecture I didn't sign up for and wish I didn't choose because of my knowledge of the movie that was made.

Oliver Sacks puts poetry into psychology

Would you recommend this audiobook to a friend? If so, why?

I would recommend this book to my friends because it is an amazing voyage you are taken on through the professional eyes of Oliver Sacks. His descriptions are poetic and allow you to understand that disease is not uniform especially anything that effects the brain.

What did you like best about this story?

I loved the history of each patient and how the past of each person interacts with the L-DOPA given to each patient. Truly amazing in its artistic quality.

What does Jonathan Davis and Oliver Sacks bring to the story that you wouldn’t experience if you just read the book?

Oliver Sacks is quirky and his introduction is almost parallel to Robin Williams in the movie version of the book. Jonathan Davis is truly amazing in his connection to the subject. With Jonathan Davis as a narrator to some of the most amazing and saddening events in peoples lives there is a pathos that is undeniable and will tug at you in the most elemental or human ways.

Was there a moment in the book that particularly moved you?

When one of the patients started to have hallucinations of a visitor to her room. She would start to get prepared for company and await her late night gentleman caller. It is amazing to hear just what human beings are capable of.

Any additional comments?

Amazing! Read the book. Watch the movie. Watch the documentary. Rethink what makes you...you.

Nerding out.

This is probably the 5th Oliver Sacks book I've read and listened too. I can't get enough. Neurology is fascinating <3 the narrator brings these people to life. All the feels.

Fascinating Story

This is an amazing story of an illness and of the effects of a drug on the illness, if only for a short time. It is well told and performed.

Absolute classic!

Sachs does a marvelous job of taking one through the science of "sleepy sickness" and then immersing one in the lives of the poor souls affected by it. We see their "rebirth" into life and how some came to chose the return to total immobility once more. Like so much of Sachs' work, this is a strange and wondrous portrayal of neurology and this bizarre and glorious experience we call human life. (If you saw the movie years ago... be prepared for a rather long--but necessary primer on the science of the illness in the beginning of the book. It is not a novelization. It is first and foremost a science book.)

Reads like a text book

Expected a novel. Interesting case studies but too technical and medical jargon for my understanding at times.

Powerful!

A science fiction awe inspiring grip, on an historical event, that leaves one in tears. Beautiful!