Awakenings

By: Oliver Sacks

Narrated by: Jonathan Davis, Oliver Sacks

Length: 13 hrs and 8 mins

Publisher's Summary

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)

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.)

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.

Ugh! This book is all repetition and failure

Narrator was wonderful. It is a feat to pronounce so many medical terms over and over again. This book was impossible for me to get through, a huge number of case studies of failed L-Dopa treatments. Save your money and time. The subject matter is interesting, but unless you are a physician this book will likely not be pleasant to endure.

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.

Sleeping sickness epidemic

Oliver Sacks M.D. was an eminent neurologist. He died in his home in New York City at age 82 in August 2015. Dr. Sacks has written many books but is most famous for his book “Awakenings.” On hearing of his death, I decided to read his book again.

In 1966 while working as a neurologist for Mount Carmel Hospital in the Bronx he noted many patients had spent decades in a strange frozen state with some symptoms of Parkinson’s disease. They were the survivors of the 1916-1917 encephalitis (Sleeping Sickness) epidemic that swept the world during World War I. I studied about this epidemic in school but remember seeing patient in this frozen state from the brief epidemic that hit the central states and prairie provinces of Canada in the early 1950s.

Sacks treated these patients with an experimental drug called L-dopa, which enabled many of the patients to recover. The book is a collection of stories about the recovery of some of the patients. The book is written using medical terminology so non scientific reads may have a problem with frequent trips to the dictionary.

A play by Harold Pinter was successful and a 1990 film starring Robert De Niro and Robin Williams was on the Oscar list. Jonathan Davis did a good job narrating the book.

A living Klein bottle

Any additional comments?

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.

WONDERFUL

My husband wanted me to get this for him. We had seen the movie and loved it. He had read other books by Oliver Sacks and enjoyed each one. This did not disappoint....loved every minute of it and the narration was terrific as well. To inject the personalties of the patients aided in understanding the different problems that each one had before going to "sleep" and after they awakened was very interesting, sometimes sad, sometimes funny - just wonderful. The patients themselves were often humorous and knowing the difficulties they faced enlightened the situation. My husband, being a Parkinson's patient, could relate to some of the difficulties of the disease.
THIS IS HIGHLY RECOMMENDED TO OTHERS!

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.

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.

Wasn't my favorite, but an important and interesting event

The events, the story of what happened with these patients is amazing, but this is not Sachs best writing. It is often stiff and it isn't until he quits with the character studies, really the post script 10 years later, that his warmth comes through.

Not at all too technical

in response to a negative review that this book didn't work in audio
i cannot agree
the terminology shouldn't cause a problem to most people considering this type of book.
There is repetition due to this being a study of many cases of the same disorder but that just allows one to gain a deeper understanding

Too medically technical for an audio book

The world wide epidemic after the First World War of encephalitis lethargica, commonly known as sleepy sickness, was a fascinating puzzle for those interested in neurology and brain chemistry and a terrible experience for the sufferers and their families. Many patients died relatively quickly but some patients were in a semi-unconscious state for decades. This book charts the life histories of a series of patients treated by the author starting in the early sixties some of whom were initially miraculously transformed by L-Dopa administration. The initial promise that this neurotransmitter precursor could reverse the complete shut-down of some patients was short-lived as many developed severe side effects.

I haven't given this book a high rating as I don't think it works as an audio book. The author peppers the book with medical terms that most non-medics will find perplexing. I have a brain research background but found that after the first few descriptions of patient histories the narrative became repetitive and I felt I was listening to a continuous series of case conferences.

very interesting

Any additional comments?

great listen, drags out a wee bit from time to time but well worth the effort, some fascinating life stories.......the human animal is truly a complex and interesting species

This is a dull and overly detailed medical paper.

What would have made Awakenings better?

I believed it was a novel. I was just an audio version of a medical journal which (unless you were specifically interested in the subject mater) was a very dull listen.

Would you ever listen to anything by Oliver Sacks again?

Very unlikely.

What didn’t you like about Oliver Sacks and Jonathan Davis ’s performance?

It was just dull medical detail. no real story.

You didn’t love this book--but did it have any redeeming qualities?

Not for me.

Any additional comments?

I would like to return if possible and make a fresh selection please.