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40 of 41 people found the following review helpful
5.0 out of 5 stars Awakenings: the full story behind the film
You'll probably have seen the Robert de Niro film. This is the original book by neurologist Oliver Sacks, describing the L-dopamine drug trials that awakened patients 'frozen' for decades by Parkinsonian symptoms. A harrowing but sympathetic account, the book has room for the complexities missed by the film. After dramatic initial awakenings, the unpredictability of...
Published on 29 Mar 1999

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4 of 4 people found the following review helpful
1.0 out of 5 stars Hell inside Mt. Carmel Hospital, courtesy of Dr. Sacks
This is one of the most disturbing and horrific books I have ever read.

In it, Dr. Sacks demonstrates admirable, almost super-human devotion to the few dozen tragically, hopelessly, severely ill patients under his care at a chronic care institution in the late 1960s. He makes the rational and defensible decision to try a promising new drug, L-dopa, on them...
Published 3 months ago by Rover


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40 of 41 people found the following review helpful
5.0 out of 5 stars Awakenings: the full story behind the film, 29 Mar 1999
By A Customer
This review is from: Awakenings (Paperback)
You'll probably have seen the Robert de Niro film. This is the original book by neurologist Oliver Sacks, describing the L-dopamine drug trials that awakened patients 'frozen' for decades by Parkinsonian symptoms. A harrowing but sympathetic account, the book has room for the complexities missed by the film. After dramatic initial awakenings, the unpredictability of drug reactions gave varied patient histories that ranged from disastrous relapse to modest long-term success. Far less 'feelgood', but ultimately more hopeful, than the film.
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4 of 4 people found the following review helpful
1.0 out of 5 stars Hell inside Mt. Carmel Hospital, courtesy of Dr. Sacks, 21 July 2014
This review is from: Awakenings (Paperback)
This is one of the most disturbing and horrific books I have ever read.

In it, Dr. Sacks demonstrates admirable, almost super-human devotion to the few dozen tragically, hopelessly, severely ill patients under his care at a chronic care institution in the late 1960s. He makes the rational and defensible decision to try a promising new drug, L-dopa, on them. That's when the horror begins.

With only one exception, drug administration is a disaster. After a brief, spectacular recovery lasting a few days at most, these patients endure horrors above and beyond those previously known to them. Some are psychiatric, where, for example, civilization is stripped from cultured individuals, who then yell obscenities, assault others, and perform overt public sex acts. Of course there are hallucinations, too. The physical changes are worse: respiratory crises, uncontrollable movements, and hyper-salivation to the tune of one gallon a day. One person develops hand tics that move at a rate of 300 tics per minute (5 per second!). Sacks buries in a footnote the gruesome fact that 30% of his patients suffered a fall that causes a major bone fracture. I was sick with despair in reading what these patients endured.

All of that is bad enough, but what really got to me was Sacks' approach to these complications. He approached these careening L-dopa patients like a birdwatcher or a stamp collector -- carefully cataloging all the interesting behaviors and colors and movements in unbelievably excruciating detail (this is the bulk of the book) -- without a moment's thought to what might be causing the enormous variability in the medicine's effect over time, and without a thoughtful, professional attempt to understand and mitigate the swings in response.

Sure, he tried raising and lowering the dose of L-dopa, but he did this simple-mindedly, based only on a gross clinical assessment of the patient's immediate state. That's not an application of professional knowledge -- it's about as sophisticated as trying to get the water in a shower to be the right temperature. Never once in the book does he mention employing the principles of pharmacokinetics to understand what's happening or the folly of his dosing strategy, nor does he mention the blood-brain barrier at all (Pubmed shows articles on this topic dating to the 1940s). People go to medical school precisely to learn about concepts like this -- it's what separates them from amateurs.

It's a cliche to say that insanity is defined by doing the same thing repeatedly and expecting a different outcome. But this is precisely what Sacks did with his patients. Start with a low dose, increase until the spectacular flare of recovery, wait for the catastrophes, and then back off on the dose. After seeing this course a couple *dozen* times, you might also think he'd pause and reflect on whether he was doing more harm than good. Nope. Didn't do it. You might think he'd have a long discussion with his patients about whether they thought this was worth it. He did this a few times, but hardly in depth (he talked to them in depth about everything else *but* this, it seems).

The overwhelming impression I had is that Sacks was so wrapped up in the exotica of his patients' psychomotor responses, and constructing oh-so-erudite literary analogies about them, that he could not tear himself away to look at these people as a skeptical physician would. He says that, as a result of his experience with these patients, he can now recognize more than 300 different types of tics. Well, whoopee. If that somehow improves the management of such patients, then I'm all for it, but there is not the merest hint that it does. He was wasting his time with making slow-motion movies to document clinically useless phenomena exhibited by these patients, when he should have been looking for ways to improve drug administration.

You might say that it's possible he had indeed adopted a careful, thoughtful, individual approach to each patient without disclosing this in the book. The uniform drug administration for all patients suggests this is false. Moreover, the book's pervasive use of unexplained technical neurological terms (many obscure even to physicians) shows clearly that he is writing for a professional audience. So Sacks cannot defend himself by saying he cut out the technical details of drug dosing in order to spare his literary-minded audience.

It's a curious thing. Sacks clearly loved his patients. But he was seduced by his literary penchants. He wanted to see his patients as individuals, but instead he did the same thing for all of them, and could not bring himself to bring hard-edged science (such as it was in the 1960s) to relieve their sufferings. It's books like this which make a person glad we have all the constraints around human experimentation now. Even bright, honest doctors like Sacks cannot be trusted to do the right thing if left alone. I will never read another of his books again, which is too bad, because I loved Man Who Mistook his Wife for a Hat. I wrote this long review because I want to get everything off my chest now and out of my brain, so I don't ever have to think about this man again.
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24 of 26 people found the following review helpful
3.0 out of 5 stars Not the easiest of reads, but worth the effort, 12 Jun 2003
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Simon Southwell (Bristol, U.K.) - See all my reviews
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This review is from: Awakenings (Paperback)
If you are looking for 'the book of the film' you may be disappointed. If you have enjoyed reading other Oliver Sacks books you may also be disappointed. However, it is definitely worth the effort as it is more illuminating than the film, if less dramatic---but no less tragic for that. The book is more technical than one might expect; plenty of case histories and medical information. But Sacks is a humanist with compassion for his patients, and this still shines through the more 'dry' format of the text. I'm glad I stuck with the book as it explains much that simply isn't possible in a film---which has different objectives in any case.
I enjoyed this book, though not as much as some of his other work, and acknowledge that it may not be for everyone.
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1 of 1 people found the following review helpful
4.0 out of 5 stars Fascinating description of an episode in our human and medical history., 10 Aug 2013
By 
Sally Baker (Suffolk, England) - See all my reviews
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This review is from: Awakenings (Kindle Edition)
I wanted to read this book after finding other books by Oliver Sacks so interesting. It has been a long, hard and emotional read as there is a lot to absorb and it really gets you thinking. It wakes you up to the fact that the human brain is utterly amazing and that we (humankind) know so little of what makes us tick. It makes you thankful that there are people out there like Oliver Sacks, who devote themselves to their callings, spending huge amounts of time and effort documenting results of their work and actions, listening to their patients and trying their utmost to come to some understanding of these individuals' feelings and circumstances.
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1 of 1 people found the following review helpful
5.0 out of 5 stars Stimulating reading, 16 July 2013
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This review is from: Awakenings (Paperback)
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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1 of 1 people found the following review helpful
5.0 out of 5 stars Enthralling and terrifying in equal measure, 20 Dec 2012
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This review is from: Awakenings (Paperback)
Oliver Sacks, a singularly humane writer and physician, provides the case histories of 20 institutionalised people who are suffering the appalling sickness disease that struck around the time of the first world war (though not connected), whom he encountered professionally in about 1970. Specifically he describes the "Awakening" affect of L-Dopa on these people.
But beware that these histories do not make for comfortable reading as these people suffer in a way that few others have.
As ever, Sacks is absolutely brilliant at seeing the person behind the affliction, and the big message behind the whole book is to argue that medicine is not just an objective scientific activity, but that seeing the subjective "I" of each individual patient in terms of physiology, psychology, social environment etc. is also of vital importance. He supports this position with many examples of how the patients react to changes to their personal cicumstances.
I found the case studies at times harrowing, and was very grateful for the 1982 epilogue contained in my 1990 copy that contained positive updates on a number of the patients.
As well as his own words, Sacks includes quotes from a number of poets (Donne in particular) and philosophers (Kant, Leibnitz, Nitsche) that are used to illustrate his position very effectively.
I am left somewhat in awe of this book and recommend it to anyone with an interest in either medicine or how people come to terms with unbelievably trying circumstances.
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8 of 10 people found the following review helpful
5.0 out of 5 stars A wonderful book about a complex and intriguing condition., 5 Sep 2008
This review is from: Awakenings (Paperback)
This is one of the best books I have ever read. It relates the "awakenings" experienced by post-"sleepy sickness" patients who survived the 1920's epidemic to live with deeply Parkinsonian symptoms. Real Rip-Van-Winkles woke up to changed selves and changed worlds.

This account of the disease's progress, the patients' experience, and the effects of L-dopa is overwhelming in its truth, sincerity, and above all, its humanity.

I particularly enjoyed the section at the end of the book in this edition, where one gains an insight into other ways to understand the disease, including the use of non-linear equations, and the application of Chaos theory to understand the side effects of L-dopa.
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2 of 3 people found the following review helpful
4.0 out of 5 stars fascinating,sensitive, 1 Feb 2013
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This review is from: Awakenings (Kindle Edition)
I saw the film of this with robin Williams' excellent and sensitive portrayal of the doctor/author. I also enjoyed this book on my new kindle fire. There are a lot of medical terms in his book, I was not expecting this so I was very pleased to be able to instantly refer to my on -screen dictionary at click of a button on my kindle. He is a very sensitive author and doctor and I feel quite strongly for the plight the patients found themselves in after contracting the sleeping sickness. The mind and the chemicals within us are a fascination to me. Are we just a bunch of chemicals, our personalities and very being controlled by chemicals/hormones within us? Fascinating subject matter.

It is amazing how the right medication managed to awaken these patients who had been effectively asleep for decades.
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1 of 2 people found the following review helpful
4.0 out of 5 stars Good for those interested in neurology, 26 July 2013
This review is from: Awakenings (Paperback)
I have not seen the film that is associated with the book so cannot comment on how it lives up to or does not live up to expectations as other reviewers have. As a book, I have found it very interesting. There are a lot of footnotes which can make for disjointed reading if you want to read them all, but they could be skipped if you do not wish to go into so much depth. The prologue to the book is long and gives a historical picture of the time of the epidemic of sleeping sickness. Again, this could be skipped if it does not interest you. The main book is made up of a number of case studies, written in Sacks's usual engaging yet compassionate style. If you are interested in neurology you will probably enjoy this book.
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5.0 out of 5 stars Five Stars, 18 July 2014
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This review is from: Awakenings (Paperback)
Brilliant copy, excellent condition
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Awakenings
Awakenings by Oliver Sacks (Paperback - 10 May 2012)
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