forms of imprisonment

AwakeningsAwakenings by Oliver Sacks
My rating: 4 of 5 stars

The story is thrilling: the sleepy sickness epidemic that followed WWI left many people with profound Parkinsonian symptoms; some were hardly able to move, never spoke, seemed frozen in time for forty years. A large number of these patients were under Sacks’ care at Mount Carmel hopital in New York in 1969 when he decided to try giving them the new drug L-DOPA, and witnessed many of them coming suddenly, vividly to life. But this blurb summary is a gross simplification! Sacks is at pains even in the introductions to point out that L-DOPA is extremely unpredictable, producing different effects even in the same patient, and always leads to some ‘tribulations’.

Also, the case studies that form the dramatic heart of the book were less fascinating to me than Sacks’ writing around them. In a way, the case studies are richly personal: Sacks insists again and again on treating patients as people, that ‘nothing can be reduced to anything’ and that ‘if we do not listen to our patients we will never learn anything’. However, the clinical detail is extensive and given in terminology that takes time to get used to. When Sacks reflects on their implications, in contrast, he writes in expansive, lucid prose, linking the mysteries of Parkinsonism to quantum mechanics and to lyrical, existential poetry.

This is a wonderful book for writers, because, as often in Sacks’ work, it goes to the heart of what forms character, identity, personality. When he asserts that ‘style is the deepest thing in one’s being’, I am struck by the resonance with some of the most thought-provoking philosophy and criticism I have read. The succinct expression here is powerful, and it is fleshed out by meditations on the notion of health as musicality and free flow, of being as moving, which the ‘phantasmagoria’ of Parkinsonism most graphically disrupts and distorts.

A section on stage and screen interpretations of the original work is included. Sacks, initially concerned that any adaptation would be ‘unreal’ was delighted by Pinter’s response A Kind of Alaska: “I felt Pinter had given me as much as I gave him: I had given him a reality – and he had given me one back.”

Ultimately, Sacks eloquently calls for an existential medicine. Over and over he emphasises how deeply affected patients are by their effective imprisonment in a ‘Total Institution’ and describes how they respond to music, visitors, trips out, as well as to the physical and care environment, in extraordinary and radical ways. Awakenings allows us to glimpse deep truths about health and disease, and their integrity with personhood, that should transform the ways we think about them.

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