Awakenings

*** By Oliver Sacks.

For those of you who are like me and haven't seen the movie, Awakenings chronicles a medical phenomenon that began in 1969. Back in the 19-teens and 20s, a good many people were stricken with encephalitis and, though they recovered from the encephalitis, spent the following decades plagued by Parkinsonian symptoms: catatonia and rigidity or, alternately, spasticity and general too-muchness. In the late 60s, dopamine (L-Dopa) was used to treat Parkinsons patients, and Sacks tried it on the post-encephalitic patients as well. The results were astonishing, breaking people from their prisons of the last forty or fifty years — but, ultimately, with mixed and unpredictable results.

Sacks discusses the background and medical aspects of the L-Dopa phenomena (yes, plural) in goodly detail, but the most fascinating part of the book, where most of the real meat lies, is in the case histories of 20 patients treated with L-Dopa. Every case is unique. For some individuals, the medication brought great hope for the future; for others, utter despair. Everyone was changed.

The histories are a testament to both the marvels and the limitations of modern medicine. They illuminate an aspect of medical treatment that must not be ignored: medicine, as a physiological treatment, is not a solution by itself. The individual's character and determination, and the individual's social and physical environments, have at least as much influence. The patient who says "I will go home tomorrow" and the patient who says "I will die tomorrow" have more influence on their own destiny than most logicians would allow.

This is definitely a worthwhile read. If you feel yourself getting bogged down in the medical discussions, just skim them and skip to the case histories. That's where the real stories are.

Posted by Lisa on August 23, 2002 02:21 PM